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Metallic implants/prosthesis – are they MRI safe?

28th October 2018, Dr Chee L Khoo

Metallic objects, implants or prosthesis can render magnetic resonance imaging (MRI) unsafe or affect the quality of the images. Our patients who have metallic joint prosthesis in-situ not uncommonly require further imaging. This can pose a bit of a challenge as many of the same patient population who require the joint replacement are the same population of patient that require further imaging.…

3D Mammogram – is there a role in clinical practice?

30th September, 2018, Dr Chee L Khoo

There is no question that screening mammograms have led to a decline in late stage breast cancers. There have been a gradual decrease in breast cancer mortality, at least partly, due to the introduction of screening mammograms over the last 25 years. But screening mammograms are not perfect. In women with dense breast tissue, the sensitivity of mammogram decreases.…

Non-invasive prenatal screening – A package deal

Increasingly, women are now requesting non invasive prenatal screening. Spectrum Medical Imaging now offers a comprehensive non-invasive prenatal screening at Liverpool.

For patient convenience, they provide pre-test discussion, a viability/dating scan, GeneStyle NIPS and 13 week structural scan. NIPS results are available within 5 days. Genetic counselling for NIPS if required post test.

Click here for more details.…

Prostatic arterial embolisation – another option for BPH

1st August, 2018, Dr Chee L Khoo

Benign prostatic hyperplasia (BPH) is increasingly more common when men gets older. Transurethral resection of prostate (TURP) is still the gold standard treatment for most patients. Since alpha-adrenergic antagonists (also called alpha blockers) came to market, TURP is performed a lot less often. 5-alpha reductase convert testosterone into 5-alpha-di-hydrotestosterone (DHT), which is responsible for prostate hypertrophy and blocking this enzyme prevents further prostate growth.…

Interventional Radiology – so many places you can stick a needle at!

July 1st, 2018, Spectrum Radiology

It’s absolutely amazing where and what they can inject or biopsy these days. The list is just mind boggling. Ok, not everyone is equipped and experienced to do those procedures. And the outcome does depend on the expertise of the operator. Have a look at the list of interventional procedures possible here.

Dr. Glen Schlaphoff and Associates, in collaboration with Spectrum Medical Imaging have established an integrated clinical service for interventional radiology. …

Insurance Claims Made Easy (with help from some friends)

Don’t we all hate the paperwork and the hassle of insurance claims – workers compensation, CTP or similar. And to have to chase after the unpaid invoices months after the case have closed. Since, January this year (I think), there have been some positive changes to the whole NSW Workcover system. Is it just me? I don’t recall being notified about the changes.…

CT and US Guided Injections – what goes where for what conditions

Interventional procedures have evolved and improved over time since epidural injection was first introduced for low back pain and sciatica in 1901. One of the major contributors in the improvement of these interventions is the advancement of imaging guidance technologies. The utilisation of image guidance has dramatically improved the accuracy and safety of these interventions.

It is sometimes confusing to know what injections go where for what conditions?…

Opioids or codeine not recommended? What do we do with patients with severe back and leg pains?

May 1, 2018 Dr Chee L Khoo

Chronic, persistent low back, lower extremity pain, and radicular pain may be secondary to disc herniation, disc disruption, disc degeneration, facet joint disease, spinal stenosis, or post lumbar surgery syndrome resulting in disc-related pain with or without radiculitis. The specificity and sensitivity of the symptoms and signs are low and therefore, not as reliable as we think in getting to the precise diagnosis.…

Prostate Cancer – to screen or not to screen

April 15, 2018, Dr Chee L Khoo

Last fortnight we review the PI-RADS score in relation to prostate MRI and i thought we might go through a real case study and how it relates to general practice. Otherwise well 42 year old gentleman with no family history of prostate cancer or any other hormone related cancers presented for general check-up in 2011  in addition to the usual coughs and colds.…

Prostate MRI – A case study

A 60 year old man presents with a rising PSA despite several previously negative transrectal prostate biopsies. A prostate MRI demonstrates a circumscribed small region of low T2 signal intensity within the left lateral peripheral zone at the gland base. This region demonstrates moderately restricted water diffusion and avid early enhancement after intravenous contrast. This appearance is consistent with a region of high grade prostate cancer.…

A GP guide to understanding prostate MRI – the PI-RADS scoring system

April 2018, Dr Chee L Khoo

Forget about whether PSA screening saves lives or not. What is the next step when a PSA level comes back elevated. Obviously if the PSA is >10 or much higher, they need referral to a urologist for biopsies. What if it is trending high or is significantly higher than the age related reference range? Patients are increasingly having prostate MRIs performed the results are reported as PI-RADS scores.…

Non-invasive prenatal testing – what GPs need to know

February 2018, Dr Chee L Khoo

You would have no doubt come across a few patients enquiring about non-invasive prenatal testing. Obviously, this come on top of the “optional” nuchal translucency (NT) with or without maternal serum analysis which has been around for some years. What does non-invasive prenatal tests (NIPT) exclude and what does it not exclude?

So, what does NIPT test for?…

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