Abbreviated breast MRI – how useful is it?

8th July 2020, Spectrum Radiology

Adjunct screening with dynamic contrast-enhanced (DCE)-MRI was first recommended for women at high (>20%) lifetime risk of breast cancer, facilitating earlier cancer detection and reducing interval cancers. Even in women at average risk of breast cancer, there is evidence that they might also benefit from screening MRI.

Apart from the cost of MRI equipment, other costs include the relatively long acquisition, limiting high-volume patient throughput and interpretation times involved in a full diagnostic protocol.…

Double thalassaemia – it’s more than double trouble

thalassaemia

22nd May 2020, Dr Chee L Khoo

Let’s imagine we have a pregnant woman who tested positive for β-thalassaemia trait (minor) on antenatal screening blood tests. If both partners carry the same thalassaemia trait, there is a 25% chance of having a baby with thalassaemia major. Thus, we are advised to screen her partner for thalassaemia as well. Say, the partner’s blood picture is normal with no microcytosis and high performance cation-exchange chromatography (HPLC) shows normal levels of HbA2 and HbF.…

Pregnancy Medical Imaging – A personalised one stop shop for pregnant women

Pregnancy medical imaging can provide vital diagnostic information about a developing baby including gestational age, checking for multiple pregnancies, congenital anomalies and/or problems with the placenta, monitoring foetal position and growth, and the level of amniotic fluid.

Who would have thought that the radiologist is now a friend of GPs when we look after pregnant women. Radiologists are key members of clinical teams who frequently make the first diagnosis of many medical conditions in children, adults and often the unborn baby.…

Breast cancer – should we offer risk reducing medications?

26th September 2019. Dr Chee L Khoo

We put patients at high risk of cardiovascular events on statins as primary prevention. We sometimes put patients with high risk of cerebrovascular disease on aspirin to prevent strokes. What about patients who are at high risk of breast cancer? Now, these are not patients who already had breast cancer. We are talking about patients who have not had cancer but are at higher than average risk of developing breast cancer.…

Abbreviated breast MRI – what is it?

22nd June 2019, Spectrum Medical Imaging

Dynamic contrast enhanced breast – MRI must contain a minimal number of MRI sequences that is necessary to detect small enhancing breast lesions. What if we cut down the number of sequences but yet have enough accuracy to detect small early cancers? That’s what AB-MRI is – less number of sequences but yet enough to detect small lesions. …

Ramadan is here – do we need to do anything different with patients with diabetes?

13th May 2019, Dr Chee L Khoo

Ramadan is the holy month for Muslims, falling in the ninth lunar month in the Islamic calendar year. Because the timing of Ramadan is linked to the sighting of the new moon, the timing of this month varies. Ramadan is a period of worship, self-discipline, austerity and charity. The most important significance of Ramadan is that Muslims are required to observe fasting during daylight hours.…

Low birth weight and future cardiovascular risk – how are they connected?

13th April 2019, Dr Chee L Khoo

We know that overweight children have higher future risk of cardiovascular disease and diabetes.  Ironically, babies who are small at birth or during infancy also have increased rates of cardiovascular disease and diabetes as adults. It is thought that foetal undernutrition at different stages of gestation are somehow link to this increased risk, but the underlying mechanism is not fully understood.…

Can drugs and supplements improve sperm quality?

12th March 2019, Dr Chee L Khoo

When couples present for investigations of infertility, semen analysis is one of the earliest investigations we order. Every so often, the results come back with reduced sperm numbers, motility or normal forms. It is frustrating as a GP when we are unable to advise them what they can take to improve their sperm parameters.…

The role of breast MRI in breast cancer detection

Many countries now recommend annual MRI screening in conjunction with mammography for high risk groups. The only problem is that different countries define high risk differently. Medicare item 63464 can be used for the surveillance and diagnosis of women under 50 years of age at high risk of developing breast cancer, and who have no signs or symptoms of the disease.…

Metformin in Pregnancy – first do no harm?

27th February 2019, Dr Chee L Khoo

Primum non nocere (first do no harm) is quite an appropriate term when is comes to managing pregnant women who either have dysglycaemia or are at risk of dysglycaemia. While there is no question that hyperglycaemia during pregnancy is associated with both poor maternal and foetal outcomes as well as epigenetic changes which can affect the next generation, who and how to treat is still debatable.…

Undiagnosed pelvic pain – is it pelvic congestion syndrome?

22nd December 2018, Dr Chee L Khoo

Endometriosis is the most frequently diagnosed condition in women with chronic pelvic pain. What if they can’t find endometriosis on laparoscopy? In 60% of women with chronic pelvic pain, the cause remained unknown. A significant proportion of these women may suffer from pelvic congestion syndrome (PVC). Is this one of those “idiopathic” type condition which is diagnosed when all tests are negative?…

Anti-phospholipid antibodies – how much do you know?

27th November 2018, Dr Chee L Khoo

I recently saw a young lady whose mother had anti-phospholipid syndrome (APL) . She is now worried whether she has the same problem and request some blood tests. She is otherwise fit and healthy. Sure, among other things, I ordered APL antibodies hoping that the pathologist will know what I was looking for. Pretty straight forward so far until the results of her tests came back.…