Screening and diagnostic technology


Fight cancer before it’s ever diagnosed

Identifying cancer at its earliest stages is the first step to successfully fighting this deadly disease. At the ETMC Cancer Institute, we’re proud to offer some of the world’s most advanced methods and diagnostic technologies for cancer screening to help patients feel more at ease during these uncertain times.

Autofluorescence and endoscopic ultrasound

content-cancer-endoscopic-ultrasoundTo help aid in the detection and diagnosis of lung tumors, autofluorescence and endoscopic ultrasound technology are often used. Autofluorescence is done by inserting a small scope through the mouth or nose and allowing it to travel down into the lungs. A video camera with white and blue light sources is attached to the scope to give the physician a clear view of the patient’s airways and help identify any abnormal cells. If problematic cells are identified, the physician may remove a small sample for further analysis.

Similarly, an endoscopic ultrasound combines endoscopy and ultrasound to obtain a visual of the lungs and the surrounding tissues. Anesthesia is rarely used during an endoscopic ultrasound, but the procedure does require the patient to be sedated. Small electrode patches are placed on the skin to monitor pulse, blood pressure and blood oxygen. Once the patient begins to feel sleepy, a long flexible tube with a small ultrasound transducer located near the tip is inserted through the mouth and lowered down the throat to examine the esophagus and lungs. Because this transducer is positioned on the tip, it’s able to obtain high-quality images that are more accurate and detailed than ones done by traditional ultrasounds. The whole procedure should last from 30 to 90 minutes depending on the complexity of the case, and there may be some slight discomfort during and after.

Patients will likely be sleepy following an endoscopic ultrasound but once fully awake, they will speak with a physician who will discuss the findings of the procedure. In most cases, patients should be able to return home following the procedure.

Learn more about lung cancer

Digital mammography

content-cancer-hologic digitalBreast cancer is currently the second leading cause of cancer death among women. The American Cancer Society recommends that all women receive an annual mammogram starting at age 40 since early detection drastically helps to increase the survival rate for breast cancer patients.

ETMC Breast Centers use the Selenia digital mammography system from Hologic to provide exceedingly sharp images in less time than a traditional mammography. These images are immediately available to our radiologists for evaluation and can be displayed on a high-resolution computer to enhance the visuals of the structures within the breast tissue. The brightness and contrast of the images can also be adjusted to help detect small calcifications, masses and other potential signs of cancer.

In addition to being available at our ETMC Breast Centers, digital mammograms are offered to patients remotely thanks to our ETMC Mobile Mammography unit. This Food and Drug Administration (FDA) approved and American College of Radiology (ACR) accredited unit is staffed by a certified mammography technologist and serves our ETMC clinics, local businesses, community events and rural areas in East Texas with the same technology.

Learn more about breast cancer

Genetic testing of tumor cells

For those who have a family history of cancer – especially breast and ovarian cancers – genetic testing of tumor cells can help you to make more informed decisions about potential screenings, early detection and treatment of particular cancers. These tests also enable our staff to more precisely identify certain types of tumors in order to prescribe the most effective therapies.

The process begins with a thorough assessment of the patient’s entire family cancer history, and if certain criteria are met, further genetic testing may be needed. A fluid test is then conducted and sent to a testing lab to extract the DNA and test for any possible mutations. Test results typically return in three to four weeks.

PET/CT scanners

content-cancer-ct-scannerUnlike techniques that provide anatomical images, positron emission tomography (PET) scans show the chemical and physiological changes related to the metabolism. Since these functional changes often occur before structural changes in tissues, PET images can show abnormalities long before they would be revealed by other methods. PET is useful for diagnosing and monitoring response to therapy for many cancers, including breast, colon, lung, ovarian, head and neck, as well as melanoma and lymphoma.

Before a PET scan, patients will receive an injection of a radiopharmaceutical – a drug labeled with a basic element of biological substances called an isotope. These isotopes distribute into the organs and tissues of the body and mimic natural substances such as sugars, water, proteins and oxygen. This radioactive substance is then taken up by the cells and allows the radiologist to visualize areas of increased activity.

Computed tomography (CT), on the other hand, provides anatomical images through a computerized imaging technique that uses radiation to create a direct image of soft tissue structures such as the gall bladder, kidneys, liver, lungs and pancreas – at varying depths. Most CT exams last between five and 10 minutes and require the patient to lie on a narrow table that gently slides into a large cylinder called the gantry. Once the patient is inside the gantry, the X-ray tube will travel around the body creating the CT images.

Two of the main devices we use for CT scans at the ETMC Cancer Institute are the Philips Brilliance CT Big Bore scanner and the Philips Brilliance 64-slice CT scanner. The Philips big bore scanner uses a fan beam and multiple rotating detectors to enhance the process of detection, diagnosis and treatment. The machine was designed with CT imaging for radiation treatment planning and allows for positioning flexibility to give the patient a more comfortable experience.

The Philips 64-slice scanner can provide sharp, clear and detailed images of any organ in seconds. The speed and precision of this machine allow our team of experts to get an in-depth look at any tumors and the surrounding areas. They also give our staff the ability to monitor changes in the sizes of tumors while evaluating progress of treatment.

Sentinel lymph node biopsy

To determine whether cancer has spread to the lymph nodes, a sentinel lymph node biopsy may be conducted. A sentinel lymph node is typically the first lymph node to which cancer cells can spread from a primary tumor. In some cases, there may be more than one sentinel lymph node. The procedure is usually done at the same time as the removal of the tumor, but can also be done before or after depending on the circumstances surrounding the cancer.

A sentinel lymph node biopsy may be performed as an outpatient procedure but in some cases may require a short stay in the hospital. The procedure begins with a surgeon injecting a radioactive substance, a blue dye or both near the tumor to locate the position of the sentinel lymph node. A device is then used to detect any radioactivity before removing the sentinel lymph node through a small incision – the least-invasive method possible. The sentinel lymph node is then evaluated for cancer cells by a pathologist, and if cancer is found, the surgeon may need to remove additional lymph nodes.

Stereotactic breast biopsy

A stereotactic breast biopsy is a procedure in which several samples of tissue are obtained from the breast through a tiny incision. This test is done to help distinguish between benign breast abnormalities and those that are cancerous. The stereotactic breast biopsy is a preferred method for tissue sampling because it permits diagnosis without the trauma or scarring of an open biopsy.

The procedure takes place in a specially equipped room at our ETMC Breast Center that houses digital breast imaging equipment and an examination table. It is an outpatient process that takes about one hour and requires a local anesthetic to be administered. A small skin nick is made into the area biopsied and several samples are obtained and sent to pathology. The pathology report is typically obtained within 48 hours, and if the results are benign, a follow-up mammogram should be completed within the following months. If the biopsy is diagnosed as breast cancer, our staff at the ETMC Cancer Institute will begin discussing immediate treatment options with the patient.

Learn more about breast cancer