Elastography: A Non-Invasive Approach to Measuring Liver Damage

By Kelly Horst, M.D.
Diagnostic Radiologist, Northwest Radiology Network

The importance of the liver to the body’s overall health is often underrated. This critical organ detoxifies chemicals, makes important proteins for the body and produces enzymes for digestion. Scarring of the liver, by liver fibrosis or liver disease, makes it work less efficiently.

The more scarring there is, the lower the function. So it’s important for physicians to be able to measure the degree of damage to a patient’s liver tissue.

Prior to the development of ultrasound elastography, the only way to measure liver damage was through a biopsy. This invasive procedure involves risk, including a risk of bleeding, a risk of infection, and a risk of obtaining poor samples.

With elastography, doctors have a newer tool to quantify a person’s risk of liver scarring and fibrosis non-invasively. Northwest Radiology Network is proud to offer ultrasound elastography in conjunction with St. Vincent Hospital at its 86th Street campus.

Elastography is useful in detecting stiffness in the liver, something doctors have known for centuries is often associated with abnormal tissue. By measuring stiffness of the liver, it can provide diagnostic information about the presence or status of disease.

To be clear: elastography does not replace liver biopsy, which is still considered the gold standard to evaluate liver tissue for fibrosis and cirrhosis. But elastography has been shown to be very helpful in determining risk for future liver damage or staging of ongoing liver disease.

And because fibrosis of the liver is diffuse, a standard biopsy can miss the diseased portion, resulting in a false negative diagnosis. Elastography, on the other hand, looks at a more representative sample of the organ.

ElastQ Imaging features a large, resizable, color-coded Region of Interest that provides quantitative stiffness analysis and the ability to perform multiple measurements on a single image. (Philips, used with permission.)

Like any ultrasound, it involves using a probe that is positioned over the skin and takes extremely high-quality pictures of the liver. The procedure is quick and completely painless.

Even more exciting than ultrasound elastography is magnetic resonance (MR) elastography, which Northwest Radiology expects to begin offering soon. MR elastography has proven to be even more accurate in determining risk for fibrosis and scarring, and has a superior capability in evaluating additional liver anatomy.

If you are diagnosed with liver disease or are at risk, or are a physician with patients showing symptoms of liver damage, elastography may be the non-invasive tool you need in assessing the disease and charting a path for treatment.

Dr. Richard Hallett II Presenting at RSNA Annual Conference

Dr. Richard Hallett II is a leading expert in cardiovascular imaging. In addition to serving as Northwest Radiology’s chief in this field, he works as an adjunct assistant professor of radiology at the prestigious Stanford University. Hallett was recently named one of Indianapolis Monthly’s “top docs” for the fourth time.

Dr. Hallett will be presenting on Peripheral Arterial Disease (PAD) and CTA of the Lower Extremity at the RSNA Annual Conference in Chicago on Friday, December 1 from 8:30 to 10 a.m.

PAD is a common cause of morbidity and mortality in developed countries. This disease is a circulatory problem in which narrowed arteries reduce blood flow to the limbs, most commonly in the legs. As stated in Dr. Hallett’s presentation, “Imaging for risk stratification and therapeutic planning traditionally involved catheter angiography. In recent years, cross-sectional imaging by CTA and MRA has proven a robust technique for non-invasive PAD assessment.” See Dr. Hallett’s presentation embedded below or click/tap here to view in another tab.

For more information about the RSNA, visit http://www.rsna.org/. And follow Dr. Hallett on Twitter @CTerrific for updates throughout his time at the conference.

Rad Tech Week: Meet Erica Hightower

In honor of National Radiologic Technology Week, we’re highlighting our amazing technologists. Meet Erica Hightower. 

Mandy and Erica

Erica Hightower is one of our highly skilled Nuclear Medicine PET/CT technologists. She is responsible for administering radioactive isotopes to patients and imaging the body part that is indicated.

She has been a technologist for 20 years and an important member of the NWR team for 16 years.

Erica has a great way of putting patients at ease with her friendly smile, positive attitude and comforting tone.

“The best part of my job is getting to know the patients I care for,” Erica said.

Erica is also a busy wife and mom who enjoys watching her kids in their sports and activities, walking and playing with her dogs, and traveling, in her spare time.

A typical work day for Erica includes: injecting and scanning patients; working up the studies and making them presentable for the radiologist; acquiring patients’ previous exams for the next day’s schedule; calling patients and going over the preps; and ordering doses for the next day. She is committed to providing the best quality care, and she is an incredible asset to the NWR team.

Rad Tech Week: Meet Donna Faraci

In honor of National Radiologic Technology Week, we’re highlighting our amazing technologists. Today we’d like to introduce you to Donna Faraci.

Donna Faraci has been a valued member of the NWR team for 21 of her 41 years as a radiologic technologist. She is experienced in CT, mammography and general X-ray, and she rotates between all three of the NWR outpatient imaging centers.

“The variety of the modalities I cover keeps my job interesting,” Donna said. “I really enjoy CT the most as it keeps me moving constantly. The best part from patients is learning a little bit about them in conversation and getting hugs occasionally. The friendships I’ve made here with co-workers are irreplaceable — I count myself lucky in that respect.”

In her free time, Donna loves scrapbooking with friends. “I am an avid scrapbooker, along with several other techs. I really love to get away for weekend scraps with them.”

Donna’s work keeps her on her toes. “There doesn’t seem to be an average day at any office, the number of patients can vary widely. Some days I feel like I need roller skates to keep up and other days we can actually get lunch.”

Although the busy schedule can take a toll physically and mentally, Donna keeps an upbeat attitude and is always greeting patients with a warm smile.

Rad Tech Week: Meet Andy Moore

In honor of National Radiologic Technology Week, we’re highlighting our amazing technologists. Today we’d like to introduce you to one of our newest rad techs, Andy Moore.

Andy Moore recently joined the NWR team, and he performs PET/CT, Nuclear Medicine, and CT studies.

Andy received his degree in Nuclear Medicine Technology from IU School of Medicine. He has been working as a Nuclear Medicine Technologist and PET/CT Technologist for almost seven years now and has been at NWR for three months.

“Dealing with the patients is easily the best part of my job. I do my best to make them laugh and feel comfortable with their exams. Sometimes you get someone that likes to joke around back with you, so it becomes a fun back and forth.”

When he’s not busy caring for patients, Andy does a lot of running and playing with his 9-month old son. “I do my fair share of reading and playing video games as well,” he said.

Some days Andy may scan up to 10-12 patients during his shift. “I eat a lot of lunches at the imaging console,” he said. But even during the busier, more challenging days, Andy maintains a positive attitude and finds the work nothing but rewarding.

“I’ve found that the best part of working here is my co-workers. Everyone has been so friendly and easy to get along with; and if you need help with anything they are always willing. It’s really a great team and a great place to work. I hope to be here for many years to come.”

We are happy to have Andy on the NWR team!

Nine Northwest Radiology Doctors Recognized as Indianapolis Monthly’s “Top Docs” of 2017

Northwest Radiology Network is pleased to announce that nine of its radiologists are ranked among the state’s top medical professionals in Indianapolis Monthly’s 2017 list of “Indy’s Top Doctors.”

“We are proud to see so many of our radiologists on this list,” said Northwest Radiology Executive Director and CFO Linda Wilgus. “This recognition inspires and encourages us to continue striving for the highest quality care.”

Congratulations to the following radiologists:

Peter D. Arfken, MD – Diagnostic Radiology

For the third year in a row, Dr. Arfken is recognized on the Top Doctors list. Dr. Arfken’s interests include body imaging and nuclear/PET imaging. He graduated from The Ohio State University College of Medicine and completed a residency and fellowship in body imaging at Indiana University Medical Center.

 

Eric E. Beltz, MD – Neuroradiology

Dr. Beltz is honored as a Top Doctor for the third straight year. His expertise is head and neck radiology and neuroradiology. He received his doctorate degree from Indiana University School of Medicine and served as Chief Resident at the University of Medicine and Dentistry New Jersey-Robert Wood Johnson Medical School at Camden. After completing his radiology residency, he completed a neuroradiology fellowship at Emory University.

 

Richard L. Hallett II, MD – Diagnostic Radiology

Dr. Hallett has been named to the list of Top Doctors for the fourth time since 2010. His special interests include cardiovascular imaging and cardiac CT angiography. He graduated from Indiana University School of Medicine and completed a residency in diagnostic radiology at Indiana University School of Medicine-Methodist Hospital in Indianapolis. Hallett teaches as Adjunct Assistant Professor of Radiology at Stanford University Medical Center.

 

Benjamin B. Kuzma, MD – Neuroradiology  

For the seventh straight year, Dr. Kuzma is recognized on the list of Indianapolis’ Top Doctors. His special interests include imaging of the brain, spine, head and neck. He performs vertebral augmentation, myelography and CT-guided biopsy. He graduated from Indiana University School of Medicine and completed a residency in diagnostic radiology and a fellowship in neuroradiology at The George Washington University Medical Center.

 

Patricia E. Ladd, MD – Diagnostic Radiology

This is Dr. Ladd’s second straight year on the list. At Northwest Radiology Network, Dr. Ladd specialized in pediatric radiology and served as medical director of radiology at St. Vincent Women’s Hospital in Indianapolis. She graduated from University of Cincinnati School of Medicine, completed her residency in diagnostic radiology at University of Kansas, and her fellowship in pediatric radiology at Cincinnati Children’s Hospital.

*Dr. Ladd is currently at IU completing a fellowship in Interventional Radiology in addition to her Pediatric Radiology fellowship.

 

john-mortonJohn A. Morton, MD – Diagnostic Radiology

Dr. Morton is honored for the fifth year in a row on the list of Top Doctors. He serves as department chair of radiology at St. Vincent Hospital and Health Services’ main Indianapolis campus. His specialties include nuclear medicine and PET imaging. He graduated from Indiana University School of Medicine, completing his residency at Indiana University Medical Center.

 

Frank J. Pistoia, MD – Neuroradiology

For the third straight year, Dr. Pistoia is named to the list of Top Doctors. His special interests include imaging diagnosis and therapy of acute stroke, and kyphoplasty. He is a senior member of the American Society of Neuroradiology and former President of the Indianapolis Stroke Coalition. He graduated from the University of Connecticut School of Medicine, completed a residency at Hartford Hospital and a fellowship at the University of Pittsburgh School of Medicine.

 

lori_wellsLori J. Wells, MD – Diagnostic Radiology  

Dr. Wells has been recognized on the list of Indianapolis’ Top Doctors for five straight years. She serves as medical director for both St. Vincent Breast Centers and is the medical director for breast imaging at Northwest Radiology. Dr. Wells’ special interests include breast imaging and intervention. She graduated from Indiana University School of Medicine.

 

Steven J. Willing, MD – Neuroradiology

Dr. Willing has been acknowledged as a Top Doctor in Indianapolis for six straight years. Dr. Willing’s professional career has spanned 20 years in academia, and he is the author of Atlas of Neuroradiology, published by W. B. Saunders in 1995. He graduated from the Medical College of Georgia. He completed a diagnostic radiology residency at the Medical College of Georgia followed by a neuroradiology fellowship at the University of Alabama at Birmingham.

*Dr. Willing recently retired from Northwest Radiology.

Northwest Radiology Named One of the Top 100 Largest Private Practices in America

Northwest Radiology Network is honored to be included in Radiology Business‘ 10th annual list of the top 100 largest private radiology practices in the United States.

Click here for an in-depth exploration of the list, which includes statements from NWR’s executive director and chief financial officer, Linda A Wilgus.

Wilgus speaks about the importance of medical groups investing in the health IT side of their practice and what else private radiology firms can do to improve their chances of success in the years ahead.

Anthem Unveils New Policy on Non-Urgent Scans

This summer, Anthem announced a new policy under which non-urgent scans performed in hospitals on an outpatient basis will no longer be covered.

For the last few years, the insurance provider has been trying to cut costs and steer policyholders seeking an MRI or CT scan to less expensive facilities.

Read this Indy Star article in which Northwest Radiology Network’s President and CEO Dr. Kent Hansen weighs in about the new policy and the importance of patient care. Watch the video below for a brief overview of Anthem’s efforts.

IDEAS Study Interim Results Show Clinical Impact of Brain Amyloid PET Scans

In early March, the American College of Radiology Research Center distributed updates in the number of active sites, registered patients, and PET scans completed, plus additional information on the importance of the IDEAS Study.

Listed below are the latest results, which show significant increases in these areas within the past six months.

 

 

 

 

 

 

 

The IDEAS Study is sponsored by the American College of Radiology (ACR) and American College of Radiology Imaging Network (ACRIN), with funding and direction provided by the Alzheimer’s Association, the ACR and the manufacturers of the FDA-approved radiopharmaceuticals for amyloid imaging. Northwest Radiology Network is proud to play a part in this important study. For more information, click here.

Northwest Radiology Network Welcomes Herman as Breast Imaging Radiologist

Northwest Radiology Network welcomes Carolyn Herman, M.D., as a new breast imaging radiologist.

Dr. Herman focuses on women’s health, particularly mammography and breast imaging. Northwest Radiology Network’s breast imaging services include screenings and diagnostic mammography, ultrasound, MRI and interventional procedure.

After receiving her bachelor’s degree from Indiana Wesleyan University, Dr. Herman received her Doctor of Medicine from the Indiana University School of Medicine.

She was the chief resident during her transitional year residency at IU Health Ball Memorial Hospital in Muncie, Indiana, and completed her radiology residency at the Indiana University School of Medicine followed by a breast imaging fellowship at Houston Methodist Hospital in Houston, Texas.

Dr. Herman is a member of the Society for Breast Imaging, American Board of Radiology, American College of Radiology, American Roentgen Ray Society, Indiana Radiological Society, and Radiological Society of North America.

With an extensive background in research, Dr. Herman has contributed to a number of presentations and publications on topics including activity in pulmonary nodules, congenital spinal cord abnormalities, ruptured ovarian dermoids and traumatic arteriovenous fistulas, among others.

Dr. Herman joins one of Indiana’s largest and most experienced staff of physicians specializing in quality high-end imaging services.