CASE STUDY. Patient History Large man, slightly overweight Large man, slightly overweight Mild hypertension, elevated cholesterol Mild hypertension, elevated.

CASE STUDYCASE STUDY

Patient HistoryPatient History Large man, slightly overweightLarge man, slightly overweight Mild hypertension, elevated cholesterolMild hypertension, elevated cholesterol CADCAD Post quadruple bypass Post quadruple bypass COPDCOPD Diabetes Mellitus type 2Diabetes Mellitus type 2 Renal insufficiencyRenal insufficiency AnemiaAnemia Previous Prostrate cancerPrevious Prostrate cancer

Preparation & Preparation & ProceduresProcedures

No preparation, came from the ERNo preparation, came from the ER Normally, make sure to remove Normally, make sure to remove

clothing/objects obstructing field of clothing/objects obstructing field of view. view.

If female make sure to ask about If female make sure to ask about chance of being pregnant. chance of being pregnant.

Make mental note of consciousness, Make mental note of consciousness, coherency coherency

Double check ordersDouble check orders

PelvisPelvis

Standard AP pelvisStandard AP pelvis Include entire pelvis, feet rotated Include entire pelvis, feet rotated

internally if possible.internally if possible. Technique: 12 mAs, 90 kVp in the buckyTechnique: 12 mAs, 90 kVp in the bucky AnatomyAnatomy

AP pelvisAP pelvis

ChestChest

Non-trauma chestNon-trauma chest Wall bucky, patient erect, Wall bucky, patient erect, PA and lateralPA and lateral Technique: 4-6mAS @ 120 kVpTechnique: 4-6mAS @ 120 kVp

Trauma (Patient on the stretcher)Trauma (Patient on the stretcher) Lateral projection using the wall buckyLateral projection using the wall bucky AP with a manual technique and gridAP with a manual technique and grid Technique: AP 8 mAs @ 120kVpTechnique: AP 8 mAs @ 120kVp

ChestChest

ShoulderShoulder

Routine protocol: 3 Routine protocol: 3 viewview 8-10 mAs @ 70-80 8-10 mAs @ 70-80

kVp, 70-80 with a kVp, 70-80 with a grid if part over grid if part over 10cm10cm

Higher mA with Higher mA with short exposure short exposure time.time.

40” SID40” SID

Trauma SituationTrauma Situation Same techniques & Same techniques &

SIDSID Position as patient Position as patient

condition allows. condition allows. i.e. for a lateral do i.e. for a lateral do a trasnthoracic. a trasnthoracic.

ShoulderShoulder

Imaging plays an important Imaging plays an important role in diagnosing tumors role in diagnosing tumors

accurately…accurately…

MRIMRILumbar Spine studyLumbar Spine study

Lumbar StudyLumbar Study

Multiple level disc disease with Multiple level disc disease with spinal stenosis, most severe at spinal stenosis, most severe at the L4-5 level. the L4-5 level.

Moderate inflammation Moderate inflammation bilaterallybilaterally

Right side exit foraminal Right side exit foraminal impingement.impingement.

No trauma or metastatic No trauma or metastatic malignancymalignancy. .

MRI MRI Sagittal SlicesSagittal Slices

CTCT

Studies preformed:Studies preformed: HeadHead ChestChest AbdomenAbdomen PelvisPelvis

CT studies done to rule out:CT studies done to rule out: Possible metastasesPossible metastases Primary lung carcinomaPrimary lung carcinoma Other pathologyOther pathology

Slices of the HeadSlices of the HeadDense area indicates lesionDense area indicates lesion

Chest CT slicesChest CT slices

When possible surgery When possible surgery is the most common is the most common treatment option. treatment option.

Other treatment Other treatment options include: options include: radiation and radiation and chemotherapy. chemotherapy.

One or more of the One or more of the treatment options may treatment options may be used in be used in combination.combination.

Facts About Brain Facts About Brain TumorsTumors

Over 120 types of Over 120 types of brain tumors.brain tumors.

3 out of 5 people who 3 out of 5 people who suffer from brain suffer from brain tumors are male.tumors are male.

Account for 1 in every Account for 1 in every 100 cancers diagnosed 100 cancers diagnosed annually in the U.S. annually in the U.S.

Five year survival rate Five year survival rate for males is 27.9% and for males is 27.9% and 30.1% for women. 30.1% for women.

DiagnosisDiagnosis

Brain lesion was found to be cancerous. Brain lesion was found to be cancerous. No surgery has been preformed due to No surgery has been preformed due to

location. location. Patient currently undergoing radiation Patient currently undergoing radiation

therapy.therapy. No further information about patients No further information about patients

current condition or recovery rate were current condition or recovery rate were available at this time. available at this time.

ReferencesReferences

Bontrager, Kenneth L. Ma, RT (R). Bontrager, Kenneth L. Ma, RT (R). Textbook of Radiographic Positioning and Textbook of Radiographic Positioning and Related Anatomy. Related Anatomy. 2001. St. Louis, 2001. St. Louis, Missouri. Pages 84-88, 177-187, 261.Missouri. Pages 84-88, 177-187, 261.

Meharry, Leroy; Ordinario, Maria M.; Meharry, Leroy; Ordinario, Maria M.; Travers, Leroy A. Travers, Leroy A. Radiologist/Doctors Radiologist/Doctors Reports.Reports. 2006. 2006. Good Shepherd Medical Good Shepherd Medical Center. Hermiston, Oregon. Center. Hermiston, Oregon.

Quick BT Facts. Quick BT Facts. Facts About Brain Facts About Brain Tumors. Tumors. 2004. http://www.braintumor.org2004. http://www.braintumor.org