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Practice Speersort

Focus: Nuclear Medicine

Speersort 8 (Passage from Mönckebergstraße 17) · 20095 Hamburg

Appointments

E: spe@radiologische-allianz.de
T: +49 40-32 55 52-102
F: +49 40-32 55 52-202

How to reach us by public transport

Rapid transit lines U & S, station “Jungfernstieg”, approx. 5 min. walk, Rapid transit line U3, station “Rathaus”, Metrobusses no. 4, 5, 6 & bus no. 109, Rapid busses no. 35, 36, 37, until station “Rathaus”

Doctors

Dr. med. Andrea Blohm Nuclear Medicine Physician  ·  Dr. med. Dirk Bumann Nuclear Medicine Physician, Radiologist  ·  Dr. med. Alexander Hoffmann Radiologist  ·  Dr. med. Viola Jansen-Schmidt Nuclear Medicine Physician  ·  Dr. med. Andreas Keulers Radiologist  ·  PD Dr. med. Thomas Kucinski Radiologist, Neuroradiologist  ·  Dr. med. Rudolf Rieser Radiologist  ·  Dr. med. Hans-Dietrich Rohwer Radiologist, Neuroradiologist  ·  Karen Schirren-Bumann Nuclear Medicine Physician  ·  Dr. med. Joachim Schubert Radiologist  ·  André Toussaint Radiologist

Speersort

Methods


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.

Radiosynoviorthese (RSO)

Radiosynoviorthese (RSO)

Radiosynoviorthese means restoration (orthesis) of the joint mucosa (synovialis) with the help of radioactive isotopes. It is a very effective method, applied in the case of painful inflammatory changes in the joints. This method has existed for two decades. A radioactive substance is injected into a diseased joint. After the injection into the joint, it distributes itself homogenously in the joint fluid. The substance is absorbed by the surface cells of the diseased joint mucosa and produces an anti-inflammatory effect. Gradually, a sloughing of the mucous surface occurs, and the mucosa swelling decreases. The finest canals from which the fluid can penetrate into the joint are closed, and the finest pain sensors are turned off. This way the pain is decreased or eliminated, and the function of the joint is improved. The effect occurs gradually, sometimes after several days, in some cases after weeks or months. The final treatment effect can be evaluated after about 6 months. 

Advantages of Radiosynoviorthese:

The actual therapy is a small intervention which can be carried out on an outpatient basis, though it has been possible only for the past few years. Rehabilitation, the way it was necessary after a traditional surgery, is no longer needed. The therapy can also be carried out on patients with an increased surgical risk. Many joints can be treated simultaneously or at short intervals. If the effect is low, e.g. if the pathological changes of joints have already advanced a lot, the therapy can be repeated. Normally it is enough to carry out one treatment on a joint.

Areas of use

The focus is on chronic polyarthritis (inflammatory rheumatism of the joints). This method is used, among other things, to treat psoriatic arthritis, active arthrosis – of the knees, for example (osteoarthritis) and for so-called irritable knee and active finger polyarthrosis.

Rheumatic complaints can also be treated using RSO. Rheumatism is an illness which affects the entire body, but its cause is largely unknown. It is an autoimmune disease – this means that the body reacts aggressively with inflammation towards parts of the person’s own body, because it recognises these wrongly as being foreign substances. This inner battle leads in particular to damage in the joints, and within them to inflammation of the joint mucous membranes (synovialitis). The joint mucous membrane often proliferates like coral, destroys the cartilage and forces its way into the bones, where it can tear ligaments and tendons, and damage or destroy joints at different speeds. In addition to treatment with medicine, joint operations are often necessary too. If one or a few joints are particularly affected, it is recommended to use radiosynoviorthese as early as possible as a low-intensity radiation therapy to prevent inflammation – if possible, before serious damage is caused to the joints.

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.

MR Angiography

MR Angiography

This method makes it possible to examine your blood vessels without surgical intervention. With the help of the magnetic field technique, we create a three-dimensional model of your vessels so we can see if everything is running “smoothly” there. It helps to recognize narrowing and tissue weaknesses (aneurysms) that may cause circulation problems, stroke or bleeding. The MR Angiography is so advanced that its image quality is the same as that of conventional angiography. In case of specific problems beyond vasoconstriction, e.g. in an upper or lower limb artery, MR Angiography provides more precise information than conventional angiography does. 

Advantages of MR Angiography compared with X-ray Angiography (DSA)

The standard method of examination used to be X-ray Angiography. For this purpose, a thin tube (catheter) was inserted from the groin into the artery. While x-ray contrast media was injected through the catheter under high pressure, we would create x-ray images which depicted the blood vessel filled with contrast agent.

MR Angiography no longer requires inserting a thin tube (catheter) from the groin into the artery. This saves approximately four hours of semi-hospitalization. In MR Angiography a contrast agent is injected into the vein. In addition to that, no x-rays are used in MRAngiography, but the vessels are visualized with the help of a strong magnetic field.

Advantages of MR Vessel examination

  • In MR Angiography, no catheter is inserted into the femoral artery. The contrast material is injected only into the arm vein.
  • In the case of specific problems, MR Angiography provides more detailed information than the regular x-ray angiography.
  • The examination is done quickly and without semi-hospitalization.
  • There are no problems such as bleeding or clotting disorders.
  • MR Angiography does not use x-rays. The vessels are shown with the help of a strong magnetic field.
  • The contrast agent used in MR Angiography does not contain iodine and can therefore be used for patients suffering from hyperthyroidism.

The procedure is completed without x-rays. However, in Germany it may only be performed by radiologists.

Sports Medicinal & Musculoskeletal Diagnostic Procedures

Sports Medicinal & Musculoskeletal Diagnostic Procedures

The focus of the practice is on musculoskeletal imaging in order to diagnose acute and chronic illnesses of the whole musculoskeletal system in adults and children. Cartilage is of central significance for the integrity of the joints. Using ultra-high-resolution MRT, an unparalleled image can be created of the deterioration of cartilage – even in its early stages. An exact diagnosis forms the basis for early and efficient treatment. Of course, we also offer measurement of bone density for the early recognition or progress and therapy monitoring of osteoporosis.

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.

CT Angiography

CT Angiography

In exceptional cases when MR Angiography cannot be performed, for example due to a pacemaker, we also offer CT Angiography. This, however, is carried out by using an iodinated contrast agent and x-rays. But the contrast agent is only injected into your arm vein and no catheter is inserted into the groin. Therefore, the CT Angiography procedure is performed as quickly as the MR Angiography. It does not require any follow-up, so you can take up your usual activities after examination. In general, this examination does not differ a lot from the MR Angiography.

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.

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.

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
MR Enteroclysis (Small Intestine)

MR Enteroclysis (Small Intestine)

With the help of the magnetic resonance imaging it is possible to see the small intestine. Thus, MRI is an alternative to conventional examination of the small intestine with enteroclysis. There is no need to insert a probe into the small intestine.

MRI helps to visualize not only changes in the inner bowels, but also thickening or inflammation of the bowel wall and its environment. The examination is used to diagnose inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis, the infestation and the extension of the disease.

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

Prostate MRI

Prostate MRI

The examination of the prostate with the help of magnetic resonance imaging (MRI) is a modern diagnostic method to combat prostate cancer. This method combines several advantages: firstly, the organ to be examined can be visually separated into different layers of tissue. Furthermore, it is non-invasive and, unlike the computer tomography, x-rays will not be used to create images. The examination of the prostate is performed with the help of two coils. The painless insertion of the endorectal coil into the rectum makes it possible for the probe to approach the prostate and thus create high-resolution imaging.

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

Who is this examination for?

  • For men who have an increased PSA level 
  • For men whose tissue sample taken after a PSA increase was benign, but their PSA level continued to increase (MRI prostate biopsy before second punch biopsy)
  • As additional guidance for the upcoming decision on treatment (e. g. surgery, radiotherapy, hormonal therapy?) for men with histologically diagnosed prostate cancer.
  • When, after removing the prostate, the PSA level rises again. Is this a local recurrence? Is there a lymph node enlargement in the pelvic area? Many radiation therapy institutions require this cross-sectional imaging procedure before the start of therapy.

Advantages and disadvantages of Prostate MRI

  • No x-rays are required.
  • A tumour, and in particular the question of the size and advancement of a prostate cancer in its surrounding. The infiltration of the seminal vesicles is safer with MRI than with other cross-sectional imaging methods.
  • The lymph nodes of the pelvis and especially the regional lymph nodes in the immediate vicinity of the prostate gland can be detected with high resolution on three levels with the endorectal coil. 

Disadvantage: In the past, severe inflammation of the prostate (prostatitis) could be similar to morphologic carcinoma and a tumour.

Low-dose CT of the Lung

Low-dose CT of the Lung

Nowadays, lung cancer can be diagnosed reliably and in a very gentle way, using so-called low-dose computed tomography. With the help of modern technology, tumours with a diameter of only a few millimetres can be detected.

The process is very suitable as an early recognition method for patients with an increased risk of lung cancer (e.g. heavy smokers). Initial studies show that many very small (< 20 mm), lung tumours can be diagnosed, which are easily operable and therefore curable.

In addition to its use as an early detection procedure for lung cancer, depending on the question to be answered and the patient’s physique, we also use low dose CT of the lung to clarify illnesses which affect the lungs only (i.e. asbestosis, sarcoidosis), and to look for tumours in high-risk patients.

Advantages and disadvantages of lung cancer early recognition with computed tomography

  • The low-dose CT in multilayer technology is considered to be the most sensitive method for early recognition of lung cancer.
  • The low-dose CT increases the chances of recovery since lung tumours can be detected in very early stages.
  • With the help of low-dose CT, lung cancer tumours that „hide“ behind vessels and diaphragm domes can also be recognized. The conventional methods do not detect these tumours.
  • With the help of computer-assisted analysis of the CT data we perform as a standard measure, the size of a tumour can be accurately measured and the smallest changes can be detected. By means of a CT follow-up examination at three to six month intervals, benign tissue changes can be differentiated from malignant ones based on a lack of growth.
  • The introduction of new detector systems makes it possible to perform lung examinations with a very low radiation dose. With the multi-slice CT technology, the radiation exposure is approximately 0.2 to 0.6 mSv. By way of comparison: every citizen in Germany is, on average, exposed to a radiation dose of about 2.5 mSv from the environment every year.
Virtual CT Colonoscopy

Virtual CT Colonoscopy

The virtual colonoscopy, also known as CT Colonography, is a new high-tech process used to look at the inside of the colon and examine it for changes. Colon polyps and tumours starting from 8 mm in size can be detected early with the help of this procedure.

The Virtual Colonoscopy has many benefits compared to conventional colonoscopy. For example, an endoscope does not have to be inserted into the colon. The „journey“ through the colon is simulated on a computer monitor.

First of all, detailed two-dimensional images are created with the help of computed tomography. These virtual cross-sectional images are then converted into a three dimensional view of the intestine by a special computer program which allows the physician to make a virtual tour of the entire large intestine. The examination is therefore much more comfortable than conventional colonoscopy; it is painless and does not require sedation.

According to previous findings, the method is as reliable as the conventional colonoscopy when detecting polyps or bowel cancer in sizes of more than eight millimetres. A disadvantage is that the doctor cannot take a tissue sample (biopsy) during the examination. If there are suspicious changes in the intestine, a regular colonoscopy should be performed additionally in each case. However, if no pathological changes were found during the virtual colonoscopy, no further action is required.

Advantages and disadvantages of Virtual CT-Colonoscopy

  • During the Virtual Colonoscopy, no endoscope is inserted into the interior of the intestine.
  • The examination is much more comfortable than the conventional colonoscopy.
  • CT-Colonoscopy is painless and requires no sedation.
  • According to current knowledge, the method is as reliable as the conventional colonoscopy to detect polyps or cancers of more than 8 mm in size.
  • The physician cannot take a tissue sample (biopsy) during the examination. If there are suspicious changes in the intestine, a normal colonoscopy must be performed in any case.
  • The examination uses x-rays. The radiation dose is about 5-6 mSv. Thus, the radiation is slightly higher than that which people are exposed to from the environment every year. This is, on average, about 2.5 mSv per year. In special cases - for example when traveling by plane - it may even be much higher.
CT Bone Density Measurement (QCT)

CT Bone Density Measurement (QCT)

Osteoporosis (from the Greek words for “bones” and “tuff”) is also referred to as “thinning of the bones” and is a common disease of the bones in old age, which makes them more susceptible to breaks. 95% of cases are due to primary osteoporosis – the type which, as opposed to secondary osteoporosis, does not occur as the consequence of another illness. 80 percent of all cases of osteoporosis affect post-menopausal women. While cases of secondary osteoporosis are rare (5%), most of these tend to need long-term treatment with cortisone (glucocorticoids).

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