Question 1

Breast Imaging

Accepted Answer

The breast imaging section offers screening, diagnostic and interventional services using various imaging modalities. This section is committed to providing high quality, evidence-based and compassionate care. We utilize the BI-RADS lexicon in breast imaging reporting and through our Picture Archiving and Communication System (PACS) are able to compare your current and past imaging in order to provide accurate diagnsoses. We have a digital mammogram machine with 3-D tomosynthesis capability which not only increases the sensitivity of mammography but also reduces patient recall rates. Being the first in the region to introduce 3-D tomosynthesis, we are well versed and hightly experienced in providing this one of a kind service. Our breast ultrasounds services offer you privacy, professional and yet compassionate care with high quality imaging. Our image guided biopsy services include ultrasound core needle biopsies, vacuum assisted biopsies and stereotactic biopsies. Our institution is the only one in the region that provides stereotactic biopsy and vacuum assisted biopsies. Vacuum-assisted biopsy (VAB) started in January 2019 and has been very beneficial in both biopsy and excision of small masses. The VAB excision offers an alternative to surgery for women with benign breast lumps that would want them excised in a minimally invasive manner. The biopsy specimens are sent to the Pathology department and working together as a team, endeavor to provide you with an accurate diagnosis by making correlation of the clinical presentation, pathology results and the imaging findings.

Question 2

General Radiography and Fluoroscopy

Accepted Answer

The General Radiography and Fluoroscopy comprises of all chest and abdominal radiographs and all diagnostic and therapeutic fluoroscopy procedures. Both acute as well as non-emergent examinations are carried out. It outlines standard and modified radiographic technique to accommodate for a wide range of patients. The general radiography and fluoroscopy section utilizes state-of-the-art equipment including Full Field Digital radiography. We also report examinations from the outreach clinics. The bulk of the fluoroscopic procedures consist of Contrast swallows, Barium meals, Contrast enemas, Micturating cystourethrography, Ascending urethrography and Hysterosalpingography.​​

Question 3

Body Cross-Sectional Imaging

Accepted Answer

Body Imaging encompasses all diagnostic and therapeutic aspects of imaging studies performed on the abdomen and pelvis with CT and MRI being the main cross-sectional imaging modalities. Our expertise includes acute as well as non-emergent thoracic, abdominal and pelvic applications including dedicated hepatobiliary, pancreas, gastrointestinal, genitourinary, transplant imaging, cancer staging and vascular applications, cardiac imaging and trauma imaging. We use state-of-the-art equipment at our facility including a 256 slice multidetector dual energy and dual source CT system with dedicated radiation dose monitoring software, 1.5 and 3 Tesla MR systems. We specialize in dedicated and advanced imaging modalities including; Cardiac CT and MRI including calcium scoring and coronary angiograms Diffusion-weighted whole body MRI especially for multiple myeloma imaging Multiparametric prostate MRI MR angiography.

Question 4

Interventional Radiology

Accepted Answer

The section of interventional radiology provides a broad range of minimal invasive image-guided vascular and non-vascular procedures including, but not limited to: Image guided percutaneous biopsy and drainage Renal intervention (nephrostomy, ureteric stent insertion) Hepatobiliary intervention (biliary drainage and stent insertion) Peripheral arterial intervention (arterial angioplasty and stent insertion) Venous intervention (central venous access, occlusions, IVC filter Embolisation (haemorrhage, varicocele, uterine fibroid) Dialysis AV fistula maintenance (venous angioplasty and stent insertion ​The section closely works with the oncology team, general surgeons, urologists and ICU/critical care teams in providing diagnostic and therapeutic interventional radiology services. We have a dedicated ultrasound room for ultrasound guided procedures, access to the CT scanner for CT guided procedures and access to the angio suite for vascular and other non-vascular procedures. Work is in progress to introduce further procedures including transarterial chemoembolisation (TACE), tumour ablation and prostatic artery embolisation.

Question 5

Musculoskeletal Imaging

Accepted Answer

This section strives to provide high-quality imaging services and interventions through our state-of-the-art facilities. Our section strongly believes in a multidisciplinary approach and we have strong ties with the Orthopedics and Rheumatology sections. Musculoskeletal Radiology involves musculoskeletal imaging and intervention for diagnosis and therapy. Modalities are Radiography, Fluoroscopy, Ultrasound, Computed Tomography and Magnetic Resonance Imaging (1.5T and 3T). Several musculoskeletal procedures are also performed in our department including Joint or bursa injection and bone or soft tissue biopsy.

Question 6

Neuroradiology and Head & Neck Imaging

Accepted Answer

This imaging is involved in imaging of the central and peripheral nervous system as well as the head and neck region using various imaging modalities. Examinations of the brain, head and neck region and the spine including CT cerebral angiography, MR angiography, and venography are carried out in this section. The section provides diagnostic support to the busy hospital neurological, neurosurgical and spine services with approximately 3500 MRI examinations annually. The clinical highlight of the week in this section is the Tuesday morning clinical meeting with hospital Neurologists and Neurosurgeons during which challenging cases are discussed.

Question 7

Nuclear Medicine and PET-CT

Accepted Answer

The Nuclear Medicine section is the only full-fledged Nuclear Medicine unit in East Africa. It performs over thirty different diagnostic and therapeutic Nuclear Medicine procedures. The faculty includes Dr. Khalid Makhdomi, who is a Nuclear Medicine Physician and heads the Section, and Dr. Samuel Nguku who is a Radiologist with specialization in Nuclear Medicine. The staff includes two Nuclear Medicine Technologists and a trained Nurse. The Section has one dual head SPECT Gamma Camera which performs the Nuclear Medicine scans, supported by a full-fledged hot lab. ​The Section also has a Bone Mineral Densitometry machine, which performs DXA and whole body composition analysis scans. In our commitment to the provision of world-class healthcare services, the Hospital has acquired an ultra-modern Positron Emission Tomography (PET) CT scanner and Cyclotron, a first in the region. What is a PET-CT Scan A PET scan is an imaging test that uses a tiny dose of a radioactive chemical, called a radiotracer, to help doctors see how the organs and tissues are functioning. PET scans are used most often to detect cancer cells in the body. PET scans usually identify diseases before they show up on other imaging tests. These diseases include cancer, heart problems and brain disorders. The radiotracer is produced by the Cyclotron unit. A low-dose CT scan is conducted at the same time to get complimentary information about the structure of the various organs and tissues. About the procedure A radiotracer is injected in a vein and usually takes upto one hour to be absorbed into the organs or tissues that are being examined. The PET scan itself may take another 30 to 60 minutes. Heart and brain studies take less time for imaging. PET/CT service is offered as an outpatient procedure unless the patient is already admitted to the hospital. Please plan for at least two hours for the procedure. The doctor will give you detailed instructions on how to prepare for your scan. After the procedure, you can continue with your normal day routine, unless your doctor tells you otherwise. Drink plenty of fluids to help remove the tracer from your body. Specially trained radiologists will review and interpret the scan images and report the findings to your doctor.

Question 8

Ultrasound

Accepted Answer

The ultrasound section at the Aga Khan University Hospital offers state-of-the-art patient services in ultrasound and is privileged to be awarded a Centre for Education (COE) status by the World Federation of Ultrasound and Medicine & Biology (WFUMB). The section performs more than 24,000 examinations each year, including but not limited to, abdominal and gynecologic ultrasound; thyroid and neck; obstetrics and gynaecology; organ transplants; ultrasound of various joints, muscles and tendons; carotid, abdominal and peripheral vascular doppler examinations. We also perform elastography of the liver to check for liver fibrosis and a whole range of ultrasound-guided biopsies and therapeutic procedures. Our six rooms are equipped with state-of-the-art ultrasound units, most with 3-D capabilities. We have portable ultrasound machines that can be deployed anywhere in the hospital including wards and casualty for point of care ultrasound (POCUS). We archive all images electronically on a picture archiving and communication system (PACS) giving us long term retrieval capability and instant comparison with previous examinations. The PACS works as a hub and spoke architecture with connections to all outreach centres of the hospital. All images are reviewed twice, once by the performing sonographer and thereafter validated by a specialist radiologist to ensure maximum quality control for all examinations.

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