Diagnostic Imaging

What is interventional radiology?

Interventional radiology is a specialized area in diagnostic imaging that uses real-time imaging (CT, Ultrasound, X-ray) to perform minimally invasive procedures. These procedures can be used to both diagnose and treat medical conditions, and are often an alternative to a more invasive surgery.

What is angiography?

Angiography is a technical term that refers to the visualization of arteries, the little tubes that carry blood from the heart. It’s traditionally done under X-ray. Although the term literally refers to arteries, it is often generalized to include any interventional radiology procedure that visualizes any type of blood vessel. Some interventional radiology departments refer to themselves as the “Angio” department.

What healthcare professionals are involved in interventional radiology?

These procedures are performed by an interventional radiologist, a medical doctor who has undergone extensive training specifically in this field. They are supported by a team of medical radiation technologists and registered nurses who work together to provide quality and efficient care.

Common procedures

Visit www.radiologyinfo.org and type in the procedure name from the list below to learn more information.

How do I prepare?

• Colon, pancreatic, stomach biopsy or feeding tube insertion
• Interventional procedures
  • CT guided lung biopsy
  • Percutaneous Transhepatic Biliary Drain Insertion
  • Percutaneous Nephrostomy Tube Insertion
  • Subcutaneous Port insertion or removal
  • Tunnelled, Apheresis or Dialysis catheter insertion
  • Ultrasound or CT guided catheter (drain) insertion or removal
  • Ultrasound or CT guided Chest, Abdomen or Pelvis Biopsy
  • Ultrasound or CT guided Renal (kidney) Biopsy
  • Ultrasound or CT guided Splenic Biopsy
  • Ultrasound guided ascites drainage catheter insertion for paracentesis or thoracentesis

X-rays are used by the CT scanner to produce images of the bones and soft tissues inside your body. The CT scanner combines a series of x-rays taken from different angles to produce cross-sectional images or “slices” of the body part being imaged.

The CT examination is relatively quick and painless. You will lie very still on a moveable table that slides through the scanner while the images are created. The medical radiation technologist can see and hear you at all times during the exam and will speak to you through the intercom.

A special dye referred to as contrast media may be used to better see blood vessels, tissues, organs, and other structures. There are different ways in which contrast media may be administered to the patient.

Female patients need to inform the Medical Radiation Technologist if there is any possibility that they may be pregnant prior to their exam.

Common Procedures

Visit www.radiologyinfo.org and type in the procedure name from the list below to learn more.

How do I prepare?

• CT Scan with Sedation (Parent Information)
• General Out-Patient CT Preparation

Frequently Asked Questions

How long will I be at the hospital?
Plan to be in the CT Department for between 30 minutes and 2 hours. The length of time will depend the exam you are having done and the preparation needed for the scan. Please be aware emergency cases and in-patients may be taken ahead of you. Every effort will be made to complete your test as soon as possible.

Can I take my medications?
Yes always take your medications with the minimal amount of fluid/food necessary.

What should I wear?
Loose clothing without metal (zippers, buttons etc.) is preferred.

What preparation is necessary for my exam?
Don’t eat anything for four hours before any abdominal scan. Don’t eat anything for two hours before all other scans. You may have CLEAR fluids (black coffee, tea, apple juice, water) until you arrive for your appointment.

Can my appointment be moved up?
We have made every effort to schedule your scan as soon possible, based on the information we have been given by your physician.

What will happen during my exam?
Depending on the exam requested you will either be lying head first or feet first . Your arms may be above your head. If your are having an IV injection of contrast dye, the technologist will be close by to make sure your injection goes well. When your exam is over the needle will be removed after a short monitoring period on the table or in the waiting area.

MRI uses very strong magnets and radio waves to take pictures of structures inside the body. The machine is large and rectangular, with a hole in the middle that creates a long tube. To take the images you must lie very still with the body part you are taking pictures of in the middle of the tube. During the scan the machine will make a number of loud noises that are a normal part of the exam. You will be given ear plugs to try and soften the sound.

For information about CT and MRI wait times, please visit the Government of Ontario’s website.

What healthcare professionals are involved in Magnetic Resonance Imaging?

The exam is performed by medical radiation technologists. The images will be viewed and reported by a radiologist, a doctor who has received special training in the interpretation of X-ray, CT, ultrasound, and MRI images.

Common Procedures

Visit www.radiologyinfo.org and type in the procedure name from the list below to learn more.

Ultrasound technology uses high frequency sound waves to look at organs, soft tissues, and blood vessels inside the body. Images are produced and then examined by a radiologist to make a diagnosis. These images can be used for both diagnosis and treatment.

Most areas of the body can be imaged using ultrasound, including abdominal organs, extremities and various joints, testes, breast, thyroid, and pelvic organs. Biopsies, aspirations, and injections of corticosteroid are also performed under ultrasound guidance. These exams are performed by trained healthcare professionals called sonographers. Sonographers are educated and trained to perform many different ultrasound exams.

Ultrasound technology is a safe and painless way to see the different tissues of the body. A small microphone-like device called a transducer sends and receives sound waves that are stored in the machine. Sound waves are used to display the distances and intensities of the echoes to form a two-dimensional image.

Common Procedures

Visit www.radiologyinfo.org and type in the procedure name from the list below to learn more.

Frequently Asked Questions

What is the difference between and x-ray and an ultrasound?
X-ray uses ionizing radiation to see bones, but are not able to see soft tissue well. Ultrasound provides a better look at the soft tissues and organs.

How will I receive my results?
Your doctors will get the results of the exam and discuss those with you. Typically, your doctor will receive the results within five business days.

How do I prepare for the ultrasound exam?
Different examinations require different preparation and some examinations require no preparation. Refer to the information you received at the time of your booking.

Why do I need to fill my bladder for pelvis exams?
A full bladder is critical in order to provide a “window” through which to see the pelvic organs. Without a full bladder the air naturally present in the bowel makes it difficult to see the organs because high frequency sound waves do not travel through air.

How is the ultrasound examination performed?
You will be asked to lie down on a stretcher or sit up on a chair. The sonographer will ask questions about your history and symptoms. They will apply a clear water-based gel to the part of your body being scanned. An ultrasound probe will be gently but firmly rubbed over the area being examined until suitable images are obtained. Sometimes the radiologist or radiology resident may also come in to scan you to better understand the information on the images.

How long will it take?
On average, scans require about 30 minutes to complete per examination. Your exam appointment time might be delayed if there are emergency cases.

What is an intracavity ultrasound? (transvaginal or transrectal ultrasounds)
In an intracavity ultrasound, special slim probes are covered with clean disposable covers and inserted into the rectum or vagina to provide more detailed visualization of the pelvic structures or the prostate gland.

Changes to shielding during patient X-rays

Effective February 5, 2024, Hamilton Health Sciences’ Diagnostic Imaging department will stop using lead shields during patient X-rays. This decision has been made after careful consideration and is in line with the recommendations of medical experts and organizations internationally, including the Canadian Association of Radiologists. Many hospitals in Canada and the United States have also stopped using lead shields as they are no longer considered effective. We aim to provide the best possible care to our patients. Please ask your Medical Radiation Technologist before your X-ray exam if you have any questions about this change. For further information, please refer to our patient FAQ.

General Radiography (plain X-rays)

General radiography requires a signed requisition (order) from a qualified medical professional. They do not require an appointment, and are completed on a first come first served basis. Please allow time for waiting when you arrive.

Plain X-rays often involve getting changed into a hospital gown. They do not involve any needles or contrast dye.

Please note that you will not receive your results right away. They will be sent to your referring doctor, who provide you with the results.

There are many types of X-ray and most don’t require preparation. The one exception is a Shapes Study. This test is only done at the McMaster University Medical Centre. It will be ordered by a specialist, usually a gastroenterologist. In order to complete this test, you will have to come to the hospital to get a package of pills that must be taken for five days before having the x-ray. The details will be explained to you when you pick up the pills.

Another type of X-ray you may receive is a pre-operative X-ray. These are X-rays that are taken in preparation for surgery.

All pre-operative X-rays are performed during your pre-op appointment. Regardless of which HHS hospital sites you are having your surgery at, or which surgeon you are seeing, your pre-op appointment will take place at the Pre-Op Clinic at the West End Clinic/Urgent Care Centre.

Fluoroscopy

Fluoroscopy is “real time” X-ray. While X-rays are still images, fluoroscopy is like a video. We use fluoroscopy to look at moving functions.

Fluoroscopy requires a signed requisition (order) from a qualified medical professional and an appointment time. Please allow time for waiting. Though you will have an appointment time, there may be delays.

Fluoroscopy often requires some preparation and involves needles or contrast dye. Pediatric patients may require sedation.

Please note that you will not receive your results right away. They will be sent to your referring physician, who provide you with the results.

Hamilton Health Sciences (HHS) now offers patients and their families access to their medical imaging records online. Once patients enrol for access they can view their entire medical imaging history at all HHS sites, share imaging instantly with any physician or even burn their own CD/USB from home. There is a $5.00 fee at the time of enrollment, and it includes permanent access to all previous imaging and radiologist reports as well as any new exams patients undergo over the following two weeks.

Patients can access the online form to enrol or fill out the paper form they are handed at the time of their registration and submit it to Diagnostic Services reception.