Tests and Investigations
Blood Tests
These are usually done to assess your general state of health, to check whether you are anaemic and to see how organs such as your liver and kidneys are working.
Chest X-ray
This will be performed to assess your general fitness and to check your heart and lungs.
Nasendoscopy
This is a short procedure, which may be carried out in the outpatient department. The Doctor or Speech and Language Therapist will use a flexible telescope (a very thin flexible tube with a light at the end), to examine the back of your mouth and throat. The tube slides through your nose to view your throat and voice box. This may be uncomfortable, but will only last a few minutes. You may be given a local anaesthetic in the form of a spray, which numbs the back of your throat. If you are given a local anaesthetic to your throat you should not eat or drink anything for about an hour afterwards until your throat has lost the numb feeling. This is because there is a risk of food or drink going into your windpipe when you swallow, or of scalding your mouth or throat with hot drinks.
Fine Needle Aspiration (FNA)
A small needle is passed gently into the swelling or lump in the neck. From this small pieces of tissue are taken and examined under a microscope to check if there are any cancer cells present. This procedure takes only a few seconds and can be carried out in the outpatients department. Generally there are no after effects but occasionally there may be slight bruising. You will be given an appointment to come back and see the doctor for the results in about 7 to 10 days.
Biopsy
To make an accurate diagnosis the consultant may need to examine a tissue sample under a microscope. To do this it is necessary to remove a small piece of the ulcer or lump. It can be done during an endoscopy, under ultrasound with a fine needle, or with minor surgery. A biopsy may be carried out in the outpatient department with a local anaesthetic, or in theatre with either a local or a general anaesthetic. If you have a general anaesthetic you may need to stay in hospital overnight.
Ultrasound Scan
Ultrasound uses sound waves to build up a picture of the inside of your body. Ultrasound imaging is painless, fast and easy. You will be asked to lie on your back on an examining table, a gel is put onto the skin in the area to be scanned and a microphone is passed over that area. There may be varying degrees of discomfort from pressure as the microphone moves over your skin, especially if you are required to have a full bladder. A computer converts the reflected sound waves into a picture on the screen. For some scans you may be asked not to eat or drink for as many as 12 hours before your appointment. The examination usually takes about 30 minutes.
Benefits
- Ultrasound scanning is non-invasive (no needles or injection in most cases) and is usually painless
- Ultrasound is widely available and easy to use.
- Ultrasound uses no ionizing radiation.
- Ultrasound provides real time imaging, making it a good tool for guiding minimally invasive procedures, such as needle biopsies
- Ultrasound images can visualise structure, movement and live function in the body’s organs and blood vessels.
Risks
- For standard diagnostic imaging there are no known harmful effects on humans.
Bone Scan
A bone scan shows up abnormal areas of bone more clearly. A small amount of a mildly radioactive substance is injected into a vein, usually in your arm. Abnormal bone absorbs more radioactivity than normal bone so these areas are highlighted and picked up by the scanner as 'hot spots' There is generally a wait of approximately 2 to 3 hours between receiving the injection and the scan-taking place. The radioactivity used in these scans is very low and not harmful. It disappears from the body within a few hours.
CT scan (Computed Tomography)
Sometimes called a CAT scan.A CT scanner is shaped like a doughnut and you will be required to lie on a couch that will move you through the machine. This test uses a rotating X-ray beam to create a series of pictures of the body from many different angles. Sometimes you will be asked to swallow a dye or given an injection of dye, which allows particular areas to be seen more clearly. This may make you feel hot all over for a few minutes. Before having the drink or injection, it is important to tell your doctor or the person doing the test if you are allergic to iodine or have asthma. CT scans take about 30 minutes and are painless. You will be able to go home when the scan is over and there is no reason that you should not drive.
Benefits
- CT scanning offers detailed views of many types of tissue including the lungs, bones, soft tissues and blood vessels
- It is painless, non-invasive and accurate
- CT examinations are fast and simple
- Diagnosis made with the assistance of CT can eliminate the need for invasive exploratory surgery and surgical biopsy
- CT scanning can identify normal and abnormal structures, making it a useful tool to guide radiotherapy, needle biopsies and other minimally invasive procedures.
Risks
- CT does involve exposure to radiation in the form of x-rays, but the benefit of an accurate diagnosis far outweighs the risk
- Special care is taken during x-ray examinations to ensure maximum safety for the patient by shielding the abdomen and pelvis with a lead apron, with the exception of those examinations in which the abdomen and pelvis are being imaged. Women should always inform their doctor or X-ray technologist if there is a possibility that they are pregnant
- The risk of serious allergic reaction to iodine-containing contrast material is rare, and radiology departments are well equipped to deal with them.
MRI Scan (Magnetic Resonance Imaging)
This is a scan that uses magnetism to build up a picture of the organs inside the body. It is completely painless, rather noisy and takes approximately half an hour. Prior to the scan you will be injected with a special dye to help make the pictures clearer. You should tell the doctor if you have a pacemaker or any metal parts inside your body such as joint replacements or surgical clips as this may mean you cannot have this type of scan. During the scan you will be asked to remain as still as possible, in a confined space. In a small number of cases patients find this claustrophobic, and if this is a concern for you, then you should discuss it with your doctor. If you wish it is possible for us to prescribe a sedative for you.
Benefits- Images of the brain and other structures of the head are clearer and more detailed than with other imaging methods.
- MRI contrast material is less likely to produce an allergic reaction than the iodine-based materials used for conventional x-rays and CT scanning.
- MRI enables the detection of abnormalities that might be obscured by bone tissue with other imaging methods.
Risks
- An undetected metal implant may be affected by the strong magnetic field. detection of radiation
- MRI is generally avoided in the first 12 weeks of pregnancy.
PET scan (Positron Emission Tomography)
A PET scan is a diagnostic examination that involves a very small amount of radioactive drug being given to you, usually through an injection into your arm. The radioactive drug will go to certain parts of your body. The PET scanner consists of thousands of small radiation detectors that measure the radiation that is being emitted by the radioactive drug within you. In this way, the PET scanner can make 3D images that show where the radioactive drug went in your body.
On the day of your scan you will be advised not to eat or drink anything for 6 hours prior to your appointment (except water). You will be given an injection of radioactive sugar into a vein that will feel similar to a blood test. There are no side effects from the injection and it will not make you feel any different. After receiving the injection you will need to rest and remain lying down for 1 hour while the injection is absorbed into your body. Once the radioactive tracer has been absorbed into your body, you will be ready for the scan. In the scanning room you will be asked to lie down on your back on the scanning bed. The bed will move through the ring of the scanner and collect images for between 30 to 60 minutes, depending on the type of scan.
Benefits Vs Risk
- Because PET allows study of body function, it can help doctors detect alterations in biochemical processes that suggest disease before changes in anatomy are apparent with other imaging tests, such as CT or MRI.
- Because the radioactivity is short lived, your radiation exposure is low. The substance amount is so small that it does not affect the normal processes of the body
- If you are pregnant or breast feeding, you should inform the staff, as the baby or foetus may be exposed to radiation.
Dental assessment
You may be advised to have a dental assessment and treatment before having surgery or radiotherapy. This is because radiotherapy can adversely affect the teeth, gums, bone supporting the teeth and saliva which protects the teeth and moistens the mouth. It is important therefore that your teeth are in their best possible condition before giving radiotherapy.
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