Cancer: Ultrasound, CT and MRI Scans

This article describes my experiences of having these three different types of scan due to my cancer. The first two, Ultrasound and CT scans, were mainly used whilst I was being diagnosed. Once it was confirmed thet I had cancer (two seperate tumours in adjacent segments of my liver) MRI scans became the norm.

I'm no expert on all these techniques so my descriptions will be from a patient's point of view, not that of a trained radiologist, doctor or scientific bod...

Ultrasound Scans

Let's take them in the order of how they seem to make people worried, starting with the least worrying of all: the Ultrasound.

The Ultrasound scan is taken with a hand-held device, a round tube attached to a wire. Before the scan takes place the operator will ask you to bare the area being scanned and you will lie down for the scan. The operator will apply quite a liberal amount of gel from a tube and smear it over the area to be scanned with her hand. He or she will be wearing surgical gloves for this. The gel can feel quite cool and a bit sticky. The end of the scanning device is then pushed against your skin through the gel and moved around whilst the operator follows progress on a video screen.

How long the scan takes will depend on the area being scanned - lots of folds in the skin can make it more difficult for the operator or any moving bits inside of you (I've also had this scan on my heart - which of course moves by expanding and contracting quite a lot) can mean the operator has to take longer.

Once the scan is complete you will be given paper towels to dry off the gel from you body and you can get dressed and leave. You won't get any results at the scanning appointment itself, it will probably take a couple of weeks or so before you get any results.

CT Scans

The CT scanning machine looks like a huge Polo mint standing on its edge on top of a table. You lie on the table which moves you into and back out of the ring or Polo mint which contains the scanning mechanism. This isn't too frightening - the ring is narrow enough for you to be able to see out of it both above you and befow you. You are not normally going to be restrained in any way though you will be asked not to move and to lie still whilst the scan takes place. This takes X-Ray pictures of your insides and a computer will later put several X-Ray scan pictures and create a 3D image for the doctors to look at.

You will experience the table you are lying on slide along horizontally whilst you lie on it until the part of you being scanned is inside the ring. For me, with my liver being scanned it meant that my head was almost clear of the ring and I could look around and admire the plain white or grey walls of the room or by looking slightly down I could see that the inner surface of the ring had a clear panel and that bits of clever-looking machinery was spinning around at times whilst the machine did its thing. Not a frightening experience. You will probably be wondering why you were so apprehensive about it by the time you are being told you're finished.

Again you will not receive any results from the scan for a few weeks after the appointment.

MRI Scan

MRI means Magnetic Resonance Imaging - these machines use powerful magnets to create an image of your internal organs. They are very powerful. If you inadvertantly were to have anything made of iron or steel on you or implanted in you - watch, jewelerry, nose rings, metal plates in your skull - this machine could make them suddenly start whizzing off in any direction, including with you in the way, at something like 400 miles per hour. You shouldn't need me to give the kilometres per hour equivalent to know that this is something you might wish to avoid... But just in case it's around 643.738 kilometres per hour... It might make you wince a bit. For the final time...

Luckily before you even get to your appointment you will be sent a letter asking you about any conditions or implants that might affect your suitability for having such a scan.

Once you get to the hospital for your scan they will take your letter and go through each point with you to ensure that [1] you understand the importance of it; [2] you understand the individual questions and [3] you have answered it correctly. You will now have a canula inserted into a vein in the inside of your elbow. This is a tiny needle prick and once the needle is inside a vein a bendy plastic tube will be slid down it into the vein and the needle withdrawn. You don't need to be frightened about having to keep your elbow rigid as there will be no needle left inside to snap off.

The canula attached to the tube is a much thicker (but I'm only talking about 1/2 an inch or 1 cm or so) tube that is basically a syringe. You may have to have a dye solution pumped in halfway through the scan - I'll talk about that in a bit. You will also be asked a few simple questions about your health.

The next step will be to make sure you are not carrying anything in pockets or in parts of a belt or in clothing or on your person that might be attracted by the machine's magnetic bits. Depending on the area to be scanned you may be asked to undress and wear a gown provided by the hospital. (You don't want bits of your fly zip or bra strap to start off at 400 mph do you?)

Now you will be taken to the scanning room. The nursing techinicians will lie you onto the table of the machine which will be taking you into and out of the machine - a tube quite a bit longer that the Polo mint of a CT. My drawing of an MRI machine above gives you some idea. You will be inside this tube for some time. I can only speak for myself. Scanning my liver involved having a fairly heavy plate placed over my stomach area for the duration of the scan. I've also had scans of my head/brain where I had to have a brace or mask made of plastic placed over my head to ensure it didn't move. It was more of a cage than a mesh so there was plenty of opportunity to see through it.

If you look for images of MRI units online they look a lot shorter than I have experienced and always have a cheerful nurse doing something and smiling reassuringly. In reality they will make sure you are in position on the table and will give you a rubber squeezy bulb in one hand which is a panic button to press if you can't cope. Note that I said "can't cope" and not "feel as if you can't cope". It is in your own best interests to go through with the scan until the end. They will then leave the room and go to monitor you and the progress of the scan from a safe place. You don't want their fly zips and bra straps flying at you either... At intervals they will ask you how you are doing and will reassure you during the scanning process.

My own pet phobia is of being in a constricted space and therefore before my first scan I was wondering how I would cope. When it came to being inside I did want to squeeze the bulb about halfway through (bearing in mind that for me (again I have to stress that point) for me the scan took somewhere between 20-30 minutes inside the machine. Which is incredibly noisy. You will have ear plugs and headphones placed into and over your ears but even so... Anyway, if you squeeze the bulb you will come out but you are going to have to try again from the start at some time. With that thought I managed to control myself enough to carry on. I'll be honest, I might have whimpered a bit once or twice but then just shut my eyes and braved it out. There's nothing to see anyway except the inside of the tube unless you really strain your eyes upward to see out of the top end.

You may have to have a dye injected into you via the canula in your wrist about halfway through the scan. This helps show up certain areas being scanned. It might feel cold and you might actually feel like you are urinating, but you won't be. All this will be explained to you before the scan and you will be told when the dye is going to be introduced.

It felt like a cool breeze was being blown by a fan down from the top end of the tube and that helped. The machine gives out a lot of very loud noise: clicks, gratering sounds (which are many clicks in quick succession I suppose)... At one point a pulse started in my forehead in time with a a particular beat from the machine. I actually thought water was dripping on my head but no.

At times during my scan I had to hold my breath to stop my lungs from moving the liver about. By default most MRIs ask you to breathe out and hold your breath. I can't do that. As a life-long asthmatic breathing out was always more difficult than breathing in, so when my lungs were empty I was in sore need of filling them again. I asked the technicians and they were happy to change the messages from the machine to ask me to breathe in and hold my breath.

I got through that first MRI. By now both due to the cancer and other side effects I've had around 30 of those scans and familiarity breeds acceptance. They don't worry me anymore. By the third one I was "Ok, so let's get this done and over with shall we?"

Once the scan is done, the operators will come back into the room, slide you out on the table, make sure you are not feeling dizzy or anything before sitting you up to get off the table and sitting you down on a chair before taking out the canula and making sure you are not going to bleed all over the place. I take blood thinners so require quite a lot of pressure on the spot when a needle or canula is removed.

So I hope that helps by knowing what such a visit to a scan might entail. Remember that these are my own particular experiences, yours may be slightly different. But it is definitely more frightening before experiencing it than it is when you are having it done.

Results will take a few weeks - four at least, though I am currently awaiting the results of my 31st MRI that was carried out six weeks ago... If I have anything else to tell you it is this: Be brave and go through with it. Far better to have it done so that any treatment can start that much more quickly. As always I wish you Good Luck with your treatment.

Family Memories: Personal