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Methods

Methods
Methods

Methods

Diagnostic Procedures

Magnetic Resonance Imaging (MRI)

Magnetic Resonance Imaging (MRI)

Magnetic Resonance Imaging (MRI) is a medical imaging technique used primarily in medical diagnostics to visualize internal structure, the function of tissues and body organs.

MRI uses electric and magnetic fields. The high-frequency pulses (radio waves) stimulate atoms with an odd mass number (dipoles) in the human body, so that they vibrate. Different types of tissues of the body are determined by different so-called relaxation times. In this way, the contrasts between organs and tissues are made visible.

Images showing the body on each possible level depict all organs in detail, thus meaning that potential pathological changes can be recognized.

The process is performed completely without x-rays. However, in Germany it may only be used by radiologists.

Practices

Computed Tomography (CT)

Computed Tomography (CT)

In Germany, Computed Tomography may only be performed by radiologists.

Unlike a regular x-ray examination, CT creates not only a simple silhouette, but also a cross-sectional image of the corresponding organ or body section. One or two x-ray sources rotate around the affected body part during recording, while the opposite x-ray detectors collect the weakened beams left after having gone through body structures (organs, bones, soft tissue).

Converted into digital data, this information provides a slide by slide picture of an anatomical cross-section that can be reconstructed and viewed on the screen.

Practices

Mamma Diagnostics

Mamma Diagnostics

The Radiologische Allianz offers the whole range of breast diagnostics along with the newest equipment. In addition to digital mammograms, we also use the following diagnostic procedures:

Tomosynthesis

In 3D tomosynthesis, three-dimensional images of the breast are created. This means that we can recognise tumours which are hidden by overlapping tissue – something which was not possible until now. The presentation of the breast tissue without anything superimposed on it makes a more precise diagnosis possible, and reduces the number of so-called false positive results.

Sonography

Sonography is an additional procedure which can be used to characterise results which cannot be evaluated reliably using a mammogram alone, and to confirm results found by touch. For women aged 40 or younger, the imaging procedure is the first choice. Women over 40 should also have a mammogram if they have high mammary gland density.

Biopsy as outpatient procedure (vacuum-assisted and punch biopsies)

Inconclusive results can be clarified by taking tissue samples under local anaesthetic. The removal of the tissue is monitored using an imaging procedure.

MR Mammography

During MRI of the breast, images are created using contrast agent. This is the most sensitive procedure available for diagnosing breast cancer. It can be used as an additional method in the case of inconclusive results, and to answer specific questions as part of post-operative aftercare.

Practices

Nuclear Medicine/SPECT/Scintigraphy

Nuclear Medicine/SPECT/Scintigraphy

Nuclear medicine has existed for many decades. It is an important component of diagnostics and therapy. 

The principle is always the same: we know certain metabolic pathways within and between the organs. Low level radiating substances (radiopharmaceuticals) are connected to substances that „go“ this way. A gamma camera detects these substances and a computer converts the information into images. At the same time, the temporal change and spatial distribution of the radiopharmaceutical in a certain area or in the whole body are recorded: that is how a scintigraphy is made. In this way, an abnormal metabolic process can be regionally allocated.

We use modern gamma cameras for nuclear medical examinations. They help to answer all questions posed to nuclear medical diagnostics. Gamma cameras can electronically register the temporal and spatial distribution of the gamma radiation emitted from the patient and send them to a data processing system. This system can process the data appearing in very large quantities within a very short period of time, visualize it and save it. In addition to this, SPECT images (Single Photon Emission Computed Tomography – nuclear medical sliced images) of a very high quality can be developed.

Practices

Digital X-ray

Digital X-ray

X-rays are electromagnetic waves which are produced with an X-ray tube for medical purposes. In German, they are named after Wilhelm Conrad Röntgen, who discovered them in 1895 in Würzburg. In the x-ray system, the x-rays developed by it are sent through the body area being examined, and then the photons let through are transmitted to a digital detector system for the development of an image. The dose is accurately recorded and documented.

The dose the patient is exposed to during an x-ray examination, is kept as low as possible. Compared with the early 20th century, less than 1 percent of the radiation dose needed at that time is needed today for creating an x-ray image.

The Radiologische Allianz has switched completely to digital radiography. The advantages are the lower radiation dose and the fact that it is possible to save the image in a digital archive. We can mostly forgo usual x-ray images. Patients will receive prints and a CD, on which the data are saved instead. So the patients can look at the results of their examination on any modern PC or tablet.

Practices

PET/CT (in the PET/CT Centre of Hamburg)

PET/CT (in the PET/CT Centre of Hamburg)

PET/CT (Positron-Emission-Tomography and Computed Tomography)

PET/CT – the most modern diagnostic procedure in oncology – reliably tracks down cancerous cells due to their increased metabolism, thus making it possible to diagnose cancer precisely, while it is still in its early stages.

The PET/CT is a combination of Positron-Emission-Tomography (PET) and Computed Tomography (CT) in one device. It combines two different imaging techniques, which makes it possible to provide an exact image of the body structure and function in one and the same image. The exact location, size, activity and spread of a tumour within the body can be determined. During a single examination under the same conditions, different advantages of both methods supplement each other, creating a good image and helping to make a precise diagnosis. Studies have shown that accuracy of diagnosis based on a combined PET/CT examination results has increased compared with two scans performed separately. For you as a patient, in addition to the optimal diagnosis there is one more advantage - only one examination appointment is needed and the examination time is half that of the separate examinations. 

PET

PET is a nuclear medical procedure which in most cases uses the low-active radioactive substance similar to dextrose F-18 fluorodeoxyglucose (FDG). Our body cells need dextrose (glucose) as a fuel, and it accumulates in many cancer cells because they grow fast and have a significant demand for fuel. The PET camera produces a picture of the distribution of sugar within the body: the healthy tissue takes up very little glucose, so „cancer cells“ can be identified. They can be recognized early and definitely with the PET, but their exact size and position cannot be determined exactly. The data is presented in a form of cross-sectional images, full-body images and three-dimensional images.

CT

CT is an established x-ray procedure which uses x-rays to create finely structured layered images of the body. In some cases it is necessary to use a contrast agent in order to create clearer images. The CT can be used to precisely define the size and position of the focal point of the cancer, but it is often not able to differentiate well enough or early enough between healthy tissue and cancerous tissue.

PET/CT and Radiotherapy

PET/CT is an important planning tool for radiation therapy. When planning Radiotherapy based on merged data provided by PET/CT, the target volumes can be defined even more precisely. The exact localization of the radiation field makes it possible to provide individual treatment and improve the chances of recovery.

For more information see www.petct-zentrum-hamburg.de

Practices

Neuroradiology

Neuroradiology

Neuroradiology is the examination and treatment of diseases of the central and peripheral nervous system with the help of imaging procedures such as Magnetic Resonance Imaging (MRI) und Computed Tomography (CT). The visualization of vascular diseases, for example a narrowing of the carotid artery, can be performed by means of MR or CT angiography instead of an invasive intra-arterial angiography. Neuroradiology is a subfield of radiology, which requires an additional specialization.

The most frequent and important examination is the MRI of the central nervous system as well as of the spinal column and brain. In many cases, such as after a nerve root compression caused by a herniated disc, it is not necessary to use intravenous contrast agents.

Many common clinical problems can be clarified with the help of computed tomography. In addition to this, calcifications and bone structures can be presented in great detail. CT Angiography can be a reasonable alternative to an MR Angiography when an especially high resolution is required, for example a tear of the posterior cerebral artery (vertebral dissection). Furthermore, the CT helps to precisely place an injection needle near a painful nervous root (Periradicular Therapy) or to make a contrasted visualization of the spinal canal (CT-Myelography).

Integrated Imaging of the Nervous System

By this, we understand the use of imaging procedures to clarify illnesses and functional disorders of the nervous system. It is less about simply showing the organ (brain, spinal cord, nerve) than about the type of disorder – modern imaging procedures can make a crucial contribution to explaining this. The procedure can be used, for example, to investigate cerebrovascular illnesses such as an impending circulatory disorder in the brain (stroke), to assess the risk of carotid artery stenosis, inflammation of the brain and spinal cord, memory disorders (dementia), illnesses of the white brain matter, tumour diseases and relapses following treatment, unclear neurological symptoms, and illnesses of peripheral nerves.

We use specific special procedures for this purpose:

  • Blood vessel examinations (MR and CT angiographies)
  • Measurements of blood flow to the brain (perfusion measurement)
  • Plaque imaging (detailed picture of a narrowing of the carotid arteries)
  • MR spectroscopy for the differentiation of changes in tissue
  • Diffusion imaging for the recognition of brain tissue affected by circulatory disorders, cell-rich changes, and nerve pathways.
  • MR Neurography

Practices

Radiation Therapy

Radiation Therapy

Radiation Therapy

Radiation Therapy or Radiooncology plays an important role in the treatment of malignant diseases. Nowadays, about 45 to 50% of all people who suffer from cancer (children and adults) can be cured with the help of modern treatment procedures. 50 to 60% of those who have been cured have undergone radiotherapy as part of their treatment.

Prof. Würschmidt
Focus „TOP 2015“
Radiation Therapy

It is carried out either as radiotherapy alone or in combination with surgical measures and/or chemotherapy. Most patients and many physicians often do not understand well enough that radiation therapy makes a significant contribution to curing cancer or is even the decisive part of treatment.

Overmore Radiation Therapy plays an important role in alleviating the symptoms of cancer disease. Many patients who can no longer be cured benefit from pain relief or restoration of body functions (e.g. ability to swallow, ability to walk). For these patients, their disease should be considered as chronic, which requires therapy measures at various intervals.

In our joint practice for radiology and radiooncology, the Radiologische Allianz offers highly modern diagnostics and Radiation Therapy for diseases of the locomotor system, of the bones, of the lungs, area of the head and neck, of the brain, abdominal and pelvic organs. Our area of specialization is diagnostics and treatment of tumour diseases.

Thanks to our various diagnostic possibilities, we can perform an individually planned treatment of tumour diseases. Cooperating closely with colleagues from various fields, we can offer you the best possible diagnostics and radiooncological therapy. It is important for us to treat you with the best possible professional competence. You should feel at ease to ask questions, to express your wishes and concerns. Our practice team is always available to help you.

The goal of the treatment is to remove the tumour completely. To achieve this we need a certain radiation dose, which varies according to the type of tumour, tumour size, surrounding normal, healthy tissue and the individual disease situation. As a rule, that means that the treatment lasts for a long period of time. In a few individual cases, a single irradiation session can be enough. The radiation therapy is a local therapy measure similar to a surgical intervention. Its effect and side effects are limited to the body regions that have been irradiated.

In order to carry out the radiotherapy as gently as possible, it is in the most cases administered gradually, which means small portions of the entire dose are irradiated every day. This way, the destruction of the tumour cells and a better protection of surrounding normal and healthy tissue can be achieved. The size of the single dose and the entire dose and the size of the irradiation field depend on the type and extent of the tumour disease. Thanks to the modern imaging systems (CT, MR, PET/CT), the irradiation planning and highly developed linear accelerators, the treatment can be carried out with high precision, very effectively and gently. High-energy x-rays (photons) and electrons that are generated by means of a linear accelerator, are applied. With the help of physical methods, the dose distribution in the body can be calculated individually and precisely for each patient. The patient will not undergo radiation exposure.

Alleviating pain using Radiation Therapy in the case of benign diseases

The therapy with x-ray is applied not only for the treatment of malignant tumours - it also plays an important role in pain therapy. 

A low-dose Radiation Therapy is a very effective method for treating painful, degenerative-inflammatory diseases of the skeleton. Therefore it is a good alternative or supplementation to other conservative treatments.

IORT, IMRT, VMAT/RapidArc, Brachytherapy, Stereotactic Radiotherapy

We also carry out special radiation therapy procedures: 

  • Intraoperative Radiation Therapy (IORT)
  • Stereotactic Radiotherapy
  • Intensity-modulated radiation therapy (IMRT) and Volume-modulated arc therapy (VMAT/RapidArc)
  • Brachytherapy

Practices

Periradicular Therapy (PRT)

Periradicular Therapy (PRT)

Periradicular Therapy (PRT) is a form of therapy that can be used in case of chronic back pains which are caused by changes in the intervertebral discs (e.g. herniated disk). The treating physician inserts a thin needle into the area of the nerve root and/or into the small vertebral joint. When the needle is correctly positioned, which is checked by computed tomography, a mixture of a local anaesthetic, a cortisone preparation and an x-ray contrast agent are administered. The medication is only active in the nerve root. An effect on the whole body is almost excluded. The intervention is carried out under local anaesthesia.

We carry out this procedure with the help of multislice computed tomography (multislice CT). Therefore, we are able to precisely check the position of the tip of a needle and we can treat the area causing pain very precisely. It is also possible to distinguish other structures such as blood vessels, bones and muscle tissue, in order not to damage them.

After four to six sessions, the patient will suffer from much less pain or will be completely pain-free.

Practices

Gamma Knife (in the ICERA)

Gamma Knife (in the ICERA)

This method is presented on a separate website:

Visit our ICERA website (opens in a new browser tab)

Practices

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