Selected Podcast

What You Need to Know Before Your Imaging Exam

Before your next imaging exam, learn more from a UVA Health System radiologist about what radiologists do and why it is so important to have your imaging done by a radiologist who specializes in the area of the body you need examined.
What You Need to Know Before Your Imaging Exam
Featured Speaker:
Dr. Alan Matsumoto
Dr. Alan Matsumoto is an interventional radiologist and chair of the Department of Radiology and Medical Imaging at UVA Health System.

Organization: UVA Department of Radiology and Medical Imaging
Transcription:
What You Need to Know Before Your Imaging Exam

Melanie Cole (Host): What does a radiologist do? And why is it so important to have your imaging done by a radiologist who specializes in the area of the body that you need examined?  My guest is Dr. Allan Matsumoto. He’s an Interventional Radiologist and Chair of the Department of Radiology and Medical Imaging at UVA Health System. Welcome to the show Dr. Matsumoto.  Tell us what is a radiologist and what role do they play in diagnosing and treating medical conditions?

Dr. Allan Matsumoto (Guest): Melanie, a radiologist is a medical doctor; a physician. We’ve gone to medical school and we spend four years of training after our internship just to learn anatomy and physiology, and the technology of how images are obtained with an ultrasound, a CAT Scan, an MRI or a PET Scan, so we can look at the pictures that are obtained to tell a patient and the referring provider what is normal, what is abnormal, what is an incidental finding, and more importantly, based upon the findings, direct the provider and the patients to the best treatment options, if it needs treatment or further diagnostic tests that needs to be provided. In addition to providing diagnostic imaging interpretation, radiologists also use imaging technology to look inside someone’s body, to figure out what a problem is and to either decide: does it need to be biopsied? And then, perform the biopsy to get a diagnosis, or to treat it like there’s an abnormal fluid collection, like an infection. They can go in and drain the infection, or identify an abnormal site of bleeding and stop the bleeding.

Melanie: You know there are many types of imaging exams now, Dr. Matsumoto and people do worry about risks. Are there any risks to the general types of imaging that radiologists perform and diagnose and look at?

Dr. Matsumoto: With any imaging test that you undergo, or any procedure you undergo, there will be risks and benefits. One risk is the cost, but the thing you’re referring to probably most prominent now is the risk for radiation exposure. That’s why it’s very important to have a trained and subspecialized and board certified radiologist involved with obtaining the examination to minimize the amount of radiation exposure and making sure that the right exam is done for the right reason, at the right time. So, with risk benefit analysis, the radiologist can have a significant impact in optimizing the benefit for the minimum amount of risk.

Melanie: Why is it so important to have your imaging done by a radiologist who specializes in the area of the body that you need examined?

Dr. Matsumoto: Melanie, much like you might take your child to see a pediatrician, or a sports injury to an orthopedic surgeon, radiologists specialize in those areas as well. So the advantage of a subspecialty radiologist is that they interpret the area of their specialty. So, a breast imaging specialist, that’s all they do day in and day out. They look at breast images, mammography, MRI of the breast. A neuroradiologist look at studies of the brain and spine. A musculoskeletal radiologist looks at knee joints, hip joints, muscles, tendons. A cardiovascular radiologist looks at the heart. So it’s very important, just like you’d want someone in your family to get the specialty care, the specialized radiologist does make a difference as compared to a generalized radiologist.

Melanie: So really it parallels the medical or surgical specialty. You want somebody that knows that part of the body really inside and out because those pictures, we see them, Dr. Matsumoto, you know we look as we kind of exit the room and really most of us don’t know what we’re looking at. How do you know what you’re looking at?

Dr. Matsumoto: With years of training and the additional specialty experience all of our faculty have done what are called fellowships. And these are extra one to three years of training to learn in specific, more detail, about the information on these images, specific to the questions that are being asked. So even though a primary care physician may order a brain MRI, when our neuroradiologists look at it, and based upon the symptoms and what the patient is complaining about, we can oftentimes direct the primary care physicians or the provider to the appropriate referrals going forward for the patient. So, clearly, a subspecialty-trained radiologist can have a significant impact on the well-being of a patient.

Melanie: How might a patient come in contact with a radiologist, Dr. Matsumoto?

Dr. Matsumoto: As we talked about, there’re really two different types of radiologists – those that do procedures and those that look at images for diagnosis. Those that do procedures come in to patients on a daily basis. Those that breast biopsy, they meet the radiologist. They talk with them. The radiologist explains what is being done. Myself, I’m an interventional radiologist. I have a clinic. I see patients there, but I also do minimally-invasive, image guided procedures and we interact with patients at the level, much like a surgeon or cardiologist interacts with a patient. The diagnostic radiologist oftentimes work with the technologists who are then performing the procedures for getting the CAT Scan and the MRIs, in conjunction with the radiologist. In those situations, the radiologist does not typically come in contact with the patient, but they will be glad to see a patient. The radiologist oftentimes interacts with the provider to ensure that the patient gets the appropriate the care and that the information is communicated to the referring provider.

Melanie: That’s a great distinction between an interventional radiologist and a diagnostic radiologist, Dr. Matsumoto. With an interventional radiologist, such as yourself, do we expect our results while you’re doing procedures, or is it we wait until your done and then you say, “Okay, it will be a day or two,” or you can give us the results pretty quickly?

Dr. Matsumoto: If it is the biopsy procedure there’s often at time period because we submit the specimen to pathologists who then look at it. And depending upon the nature of the question being asked, it can take anywhere from 48 hours to 96 hours for the pathologist to be able to look at the information. So oftentimes with a biopsy it takes a little bit of a time to get the result back. If you’re undergoing a procedure, for instance if you have an aneurism, or if you have a place of bleeding and the interventional radiologist goes in and treats the aneurism or treats the bleeding, then we often, much like a surgeon, would talk to a patient. The interventional radiologist says, “We found the site of bleeding. We believe we stopped it. We’ll know over the next few hours whether the bleeding has stopped.” So it depends upon the specific circumstance.

Melanie: Dr. Matsumoto, we have a few minutes left. Would you tell us why a patient should choose UVA for their imaging services?

Dr. Matsumoto: Well, at UVA our radiologists consider it to be a privilege to be involved in the patient’s care and we really take pride in performing the right imaging tests, or the right procedure for the right reason, at the right time. It’s very important for us to have the technology available to us, and at University of Virginia all our equipment is state-of-the-art. In addition, all the images that are interpreted and all the procedures performed are done by sub-specialists that are in that area of interest. So, they are all subspecialty radiologist. So again, a pediatric X-ray is read by a pediatric radiologist. A heart MRI is read by a cardiac MR. That makes a huge difference for the patient’s well-being. Plus the technology makes the difference. Not all equipment is the same. Those of you that have a laptop, you have a smartphone, you have a television, you know that it’s important for the state-of-the-art equipment. If your camera only takes 4 megapixel pictures, you’re not going to be able to see the level of detail to see if there’s a subtle cartilage there. So, not only are our radiologists specialized, they’re working on state-of-the-art equipment, but they’re also physically here on campus and live in the Charlottesville community.  Lastly many of our radiologists have developed the technology so once it becomes widespread we have been using it for five years. And not only that, we’re teaching other radiologists how to do this. So we are, in many instances, the expert.  A couple of other bonus points about being at UVA is we’re at multiple locations, whether it’s at the main campus, Northridge, Zion Crossroads, Fontaine, we have accessed imaging studies at night and weekends at multiple sites with all state-of-the-art equipment. And lastly patients access their reports and their images through our electronic medical record through something called MyChart and MyView. So, you put that all together, we provide the entire package; the subspecialty physicians who care, the technology that cares, the specially-trained technologists that take the images, the multiple locations patients can access and access to the information. And lastly, our radiologists are often leading the way. So we have experienced interpreting and utilizing the state-of-the-art equipment that many other institutions around us don’t have that luxury.

Melanie: That is great information, Dr. Allan Matsumoto. Thank you so much.  You’re listening to UVA HealthSystem Radio. And for more information, you can go to uvahealth.com. That’s uvahealth.com. This is Melanie Cole. Thanks so much for listening. Have a great day.