“Our practice is a bit different from elswehere” begins Dr Iain Duncan of Garran Medical Imaging.
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“We’ve designed it to be patient-centric. Everything is designed around the patient.”
GMI does many forms of imaging inside the body, but this week’s topic is narrowed down to just two modalities.
X-RAY
“The images the X-ray machines produce are digital these days instead of being on film, but the X-ray itself hasn’t changed” Dr Duncan surmised.
It is also still used to look at things like bones and lungs, and its place in medicine is like any other diagnostic test your doctor may utilise.
“The radiographer takes a picture to answer the question that the GP has asked.”
In the case of an X-Ray, “Is there arthritis? Is there pneumonia? We can usually do a yes or no answer most of the time. There might be something else causing their symptoms, but that would often need another type of test.”
ULTRASOUND
“Ultrasound is a much more complicated beast” Dr Duncan asserted.
“From a patient’s view, they’d be familiar with it in obstetrics, putting a probe on and having a look at the unborn baby.
“If they’re expecting a baby we’re looking at the baby, but the most common reason an ultrasound is performed (on anyone) is to look for the cause of their pain.”
In the room with the patient “It’s usually me and a sonographer, or just the sonographer if it doesn't need clinical input.”
However, “I’ll go in if the question hasn’t been resolved by the time the sonographer is done.”
To describe the purpose of an ultrasound, “It’s an extension of the doctor’s examination, to see things with a probe that can’t be seen by examination from the outside.
“When diagnosing we can postulate the likely causes, but a scan lets me confirm or rule it out.”
As for the machine itself, “We use Samsung ultrasound equipment. No one else in Canberra has this machine, and there are not many of them in Australia.”
The significance of this is “We’ve been involved with Samsung with the development of their ultrasound equipment. As such, we have access to software that no one else in the world has access to.”
One example is in relation to tendons and other musculoskeletal problems. With this machine the operator can measure tissue stiffness to see problems not normally visible with ultrasound.
As for the future, “Intrinsic elastography for tendons is under development and our system is unique, I don’t think anywhere else in the world is doing it.”
Another development is shear-wave elastography. “It sends an ultrasound wave into the liver and we measure the speed of the shear wave through the liver and that tells us how stiff the liver is”, which in turn ascertains the condition of the liver.
“It’s the only way, other than a liver biopsy, that you can tell how good or bad your liver is. It has changed the way they manage chronic liver disease.”