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diagnosis
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Radiology Range of services

We are experts in diagnostic radiological investigation with gentle state-of-the-art procedures. Furthermore, we offer a wide spectrum of services for disease screening and preventive health care. Importantly, at our department you will find innovative therapies that only radiologists are permitted to perform. These include innovative procedures for the treatment of back pain.

Specifically, we offer the following services:

Diagnosis - Magnetic resonance imaging (MRI)


Magnetic resonance imaging (MRI) is an ultramodern imaging procedure that provides sectional images of nearly all regions of the body, with absolutely no pain for the patient. MRI does not function with X-rays. Rather, it employs a magnetic field and therefore functions with no radiation exposure whatsoever. The data obtained by MRI appear on the computer as high-resolution, and partly three-dimensional images. Thus, nearly all tissues and organs can be viewed and assessed from all sides.

We currently work with the newest MRI devices, such as the high-field 1.5 Tesla MRI, which permits very clear depiction of different body tissues and clear differentiation of these. For children, obese or very large persons, and for patients with claustrophobia, we offer the option of being investigated in an open MRI of the newest generation.

Magnetic resonance imaging is indispensable for many diagnostic questions. It can be used, for instance, to find out whether back pain has been caused by inflammation or a prolapsed disc. MRI is especially suitable to investigate soft tissue - this includes connective tissue, muscle tissue, or nerve tissue, the brain, and organs. Even cavities filled with fluid, such as the heart, blood vessels, bile ducts and pancreatic duct, can be visualized and evaluated very well with MRI.

At our office MRI is used for the diagnosis of alterations and diseases of the following organs and tissue types:
  • Head, brain and spinal cord
  • Spine
  • All joints
  • Muscles, ligaments and cartilage
  • Arms and legs
  • Soft tissues of the neck
  • Female breast
  • Abdominal and pelvic organs
  • Bile ducts and pancreatic duct (without contrast medium)
  • Kidneys and urinary tract
  • Organs of the female pelvis
  • Prostate gland
  • Heart and cardiac vessels
  • Blood vessels (head, neck, kidneys)

You have an appointment for an MRI? Please note the following points:

Before the examination
Put metallic objects aside

Before you enter the examination room for magnetic resonance imaging, you must put aside all objects that might contain metal: money, keys, jewelry (including piercings), watches, glasses, hearing aids, removable dentures, etc. Even check and chip cards should not come be in the vicinity of the magnet because they may be rendered unusable by it. The strong magnetic field of MRI is always in operation, even when no investigation is being performed!

Pacemaker and Co.

Patients with cardiac pacemakers, implanted automatic defibrillators, and patients with one of the few older artificial heart valves and cochlear implants should not be examined by MRI. On the other hand, the following conditions are usually no reason not to undergo an MRI investigation:
  • Organic, and the majority of newer artificial heart valves
  • Implanted drug pumps
  • Metallic vascular clips or vascular implants
  • Metal implants like nails, plates and implants in bones and joints

If you have documents concerning a metal implant, please take these with you when you come for the examination.

Metal fragments in the body

Metal fragments fixed in tissue are also no risk for MRI, but the examination should not be performed when such metal fragments are located in the vicinity of the nervous system, the lungs, the eyes, or vessels.

In all of these cases, you must inform us of the fact before the examination. Our experienced staff members and doctors will be on hand with help and advice in case of doubt.

During the examination
How is an MRI examination performed?

Examination in the "tube"

Magnetic resonance imaging investigation generally takes 15 to 30 minutes. You usually lie on your back on a cot, which is driven into the tube-shaped device. To obtain images of good quality, you should like as quietly as possible. Additionally, during some examinations we may ask you to hold your breath briefly a few times. You will receive breathing commands from time to time for this purpose.

During the entire examination you will be monitored by our medical staff through a monitor, or directly in the control room.

Knocking sounds

A loud knocking sound occurs during the examination. Therefore, you may listen to music through the headphones if you wish. This will help to create a relaxed atmosphere. If desired, we can also give you earplugs.

Use of intravenous contrast medium

The use of an intravenous contrast medium is required when very similar tissue or changes in tissue have to be differentiated from each other. The contrast medium is injected through a thin plastic catheter into an arm vein during the examination.

Besides, an intravenous contrast medium helps in the investigation of tumors or localized inflammation. The use of contrast medium can also provide significant additional information in these cases, because contrast medium usually behaves differently in diseased tissue than it does in healthy tissue.

The contrast medium used in MRI is not radioactive and is generally well tolerated. Within a few hours, it is completely eliminated from the body by the urinary pathway.

Renal disease is one of the few contraindications for these intravenous contrast media. If you suffer from such a disease you must inform us about it.

Diagnosis - Computed tomography (CT)


Computed tomography (CT) is a special type of X-ray investigation. With our ultramodern computed tomography devices, we take sectional images of the investigated region in rapid sequence.

The investigation is entirely painless. The image data can be assembled into virtual three-dimensional images by a computer. Thus, the investigated portions of the body can be rotated on the computer, viewed, and evaluated from all sides.

Outstanding results with low radiation exposure
In contrast to Magnetic resonance imaging (MRI), CT employs X-rays. However, our modern ultrafast multislice computed tomography devices require very little radiation - in contrast to devices of older generations - and achieve rapid results of outstanding quality.

Short examination time
Previously the patient had to endure in the device for several minutes to take a single sectional image; in the last few years it takes just a few seconds. As one needs about 50 sectional images to cover a single region (such as the chest), the patient had to hold his/her breath several times in order to obtain pictures without motion blur. The modern CT device requires less than one second per section. Thus, the actual examination takes just a few seconds and can be easily performed by holding one‚s breath just once. The radiation exposure is also many-fold lower. Today CT is a sound, patient-friendly, and rapid method of investigation, providing images of outstanding quality for a reliable diagnosis.

Computed tomography and the radiation-free procedure of Magnetic resonance imaging are often cited as competitor methods. However, we regard the two methods as mutually complementary diagnostic measures. Depending on the region to be investigated, the diagnostic question, the patient‚s personal situation and other factors, the treating physician and our radiologists select the most suitable diagnostic method in each case. CT is given preference in emergency situations, because it provides a diagnosis in just a few minutes. The MRI examination, on the other hand, takes 15 to 30 minutes.

Applications
Computed tomography is mainly used in cases of symptoms or diseases of various body regions. It is used for the investigation of the following regions:
  • Head
CT is a valuable examination for many diseases of the brain; it can be used to diagnose a stroke, hemorrhage, or tumors in or around the brain.

Diagnosis of exclusion in several degenerative diseases of the brain (such as dementia or Parkinson‚s disease) can also be performed adequately with computed tomography. The depiction of blood vessels in the head permits conclusive statements about the patient‚s condition because of the high quality of the images.
  • Paranasal sinuses, skull base, and the bony portion of the middle and inner ear
Due to excellent depiction of very small bone structures, computed tomography permits reliable statements about injury to bone and constitutional deformities.

Inflammations or tumors and their relationship to adjoining structures in the skull base are depicted in high resolution, which is essential for planning treatment (such as an operation).
  • Jaws and the teeth
By performing a so-called dental CT, we obtain detailed images of the upper and the lower jaw. Dentists and orthodontists thus obtain exact information about the structure of the bone of the jaws and the position and condition of teeth.

Thanks to special imaging techniques, such as multislice dental CT, individual structures of the jaws and the teeth can be visualized and measured very exactly and without distortion.

A special type of software permits the investigator to use special settings and incorporate various auxiliary lines into the images. These assist in planning dental implant surgery, for instance to determine the size of the implant or the quantity of available bone substance.

The information obtained from dental CT is also significant for wisdom tooth operations and implants. The course of the mandibular nerve can determined exactly with this information, and the risk of injury largely reduced.
  • Cervical spine and soft tissues of the neck
In many patients with symptoms in the cervical spine, a reliable diagnosis can be established by performing a CT investigation. However, Magnetic resonance imaging is often given preference over CT because of its better resolution. In specific cases CT may be required as a supplementary investigation, especially when bone structures need to be evaluated.

CT is an important and informative method of examination especially to depict, in detail, the connection between soft tissues of the neck (muscles, ligaments, nerves) and the cervical spine. As the cervical spine is composed of several different structures, computed tomography is a crucial examination for exact diagnosis of injuries in this region.
  • Lumbar spine
Computed tomography is especially suitable to depict the fine bone structures of the lumbar spine. Even muscles, intervertebral discs, nerves, ligaments, and small intervertebral joints can be assessed well by this method.

In fact, CT is superior to Magnetic resonance imaging for differentiating between intervertebral disc tissue and bone structures.

Important diseases in the lumbar spine that can be identified with the aid of CT include disc prolapse or disc protrusion, and constriction of the spinal canal, which is traversed by bone marrow and nerves.
  • Bones of the arms and legs
When detecting injuries or diseases of the extremities, i.e. the arms and the legs, it is very useful to be able to exactly identify all types of tissues. This option is offered by computed tomography and its ultramodern devices. Bone and tissue as well as blood vessels and tendons can be shown clearly, and if necessary even three-dimensionally, with CT.

The bones of all joints of the extremities can be depicted in very good image quality with CT. Fine bone structures are displayed very exactly. Even infinitesimal hairline cracks or starting fractures do not escape detection by the experienced radiologist.
  • Heart
Exact imaging of coronary vessels by the procedure of so-called cardiac computed tomography (cardiac CT), the degree of calcification and - after administration of a contrast medium through an arm vein - the coronary vessels, can be depicted three-dimensionally in order to detect constrictions. This permits the investigator to estimate the patient‚s risk of cardiac infarction.

Even in patients whose constricted coronary vessels have been dilated with a balloon or in patients who have undergone bypass surgery, a cardiac CT can be performed to check the success of treatment.

For further information on screening / prevention of cardiac diseases with cardio CT, go to the section entitled Prevention.
  • Blood vessels
Magnetic resonance imaging as well as computed tomography are used for the diagnosis of alterations and diseases in blood vessels. Our experienced radiologists and the referring physician select the most suitable procedure for the respective patient and for his/her special case.

In so-called CT angiography, the high quality of the images after the administration of a contrast medium permits evaluation of the smallest details even within vessels. If necessary, colored three-dimensional images of blood vessels are produced for greater clarity. The images can then be rotated and enlarged on the monitor.
  • Lungs and the respiratory tract
Computed tomography provides the best results in depicting the lungs. Even very small ramifications of the respiratory tract and vessels are seen clearly, sharply, in great detail, with no superimposition, and in cross-section. In many cases this significantly improves the diagnosis of diseases of the lung and the respiratory tract.

The following diseases can be detected by lung CT:
  • Interstitial lung disease, such as lung fibrosis, is seen on CT even before the X-rays show anything unusual.
  • Even in diseases of the respiratory tract, such as dilatation of the respiratory tract (bronchiectasis), a CT of the lung is a reliable method to depict the extent and type of changes.
  • In emphysema of the lung, the severity and position of pathological changes can be seen clearly on CT. Inflammation of the lung can also be diagnosed well on a CT of the lung.
For information about screening/prevention of lung diseases (smoker‚s check-up) with CT, please refer to the section entitled Prevention.
  • Abdominal cavity and the pelvis
Computed tomography (CT) is ideally suited to investigate the abdominal cavity and the pelvis. The pancreas, liver, spleen, kidneys, and adrenal glands can be examined by CT in a short period of time. Here also, CT depicts bones as well as vessels on multiplanar or three-dimensional images in most impressive image quality.

Computed tomography is especially useful to detect benign and malignant tumors in the abdominal cavity. Tumors in the pancreas, the posterior abdominal cavity, the kidneys and the pelvis can be identified on CT with great accuracy. Lymph node swelling and ascites in the abdominal space also do not escape detection by CT.
  • The intestines (virtual colonoscopy)
Colonoscopy provides informative views of the insides of the bowel without the need to insert instruments into the large bowel. Instead of examining the colon directly with an endoscope by performing a colonoscopy, the investigation is "simulated" on the computer in virtual colonoscopy.

For this purpose one first performs a computed tomography of the intestines. The high-resolution digital sectional images of CT are then transformed into a three-dimensional view of the bowel with the aid of a computer program. Thus, the doctor can embark on a virtual journey of the intestines and view them from the inside.

Intestinal polyps, tumors and other pathological changes can be discovered by this method. Furthermore, the surrounding organs and structures outside the intestines can be assessed.

For more information on virtual colonoscopy please go to the section entitled Prevention.

Further examinations for which CT is frequently used include the following:
  • Examination of solid structures with a low water content, such as bones or aerated regions like the lung
  • Examination in cases of various diseases in the abdominal cavity
  • Examinations of the skull base, the paranasal sinuses, and the middle ear
  • Examination in cases of calcifications of the coronary vessels
  • Examination of patients with cardiac pacemakers and inserted defibrillators
  • Examination of patients with older cochlear implants (prostheses in the inner ear)
  • Examination of patients with metal fragments in the body (shrapnel, metal fragments in the eye, etc.)
How is a CT examination performed?
Examination in supine position

A computed tomography usually takes just a few minutes. The patient lies on his/her back on a cot, and is pushed slowly into the ring-shaped housing (or gantry) of the device.

To obtain images of good quality, the patient should lie as quietly as possible. For this reason we ask patients to hold their breath briefly now and then for some examinations. Patients are monitored by our medical staff for the entire duration of the examination.

Use of contrast media
An iodine-containing water-soluble X-ray contrast medium has to be administered for specific CT investigations. The value of a computed tomography image can be greatly enhanced by administering contrast medium through an arm vein because contrast medium permits better differentiation of the various types of tissues in the body.

During investigations of the abdominal and pelvic cavity, the patient may additionally need to drink contrast medium before the examination.

The X-ray contrast media used nowadays are usually tolerated well by patients.

Who may not be examined by CT?
Before the examination our radiologists obtain detailed information from each patient about potential contraindications for CT.

Very few obstacles exist for performing a computed tomography. The principal reason is radiation protection (such as children or pregnant women). However, in some cases a computed tomography should not be performed at all, or may be performed only when special precautionary measures are taken in regard of contrast medium. These conditions include the following
  • Known allergy to iodine-containing X-ray contrast media
  • In some diseases, such as those of the thyroid or the kidneys
  • When taking specific medications

Digital X-ray (Digital radiography)


The X-ray investigation (radiography) is of great value in medical diagnosis. It is not only the oldest, but also the most commonly used radiological method to the present day.

At our medical offices we only use digital X-ray systems, which are much more radiation-sensitive than conventional X-ray systems. They significantly reduce the radiation dose. The radiation dose required for an X-ray investigation has been reduced by as much as 90 percent compared to previous times.

A further advantage of the digital image is that it is available at other sites rapidly through data transfer. Electronic storage of the picture also permits post-processing at any time. To enhance the accuracy of the diagnosis, dark areas can be brightened and abnormal areas can be enlarged on the monitor.

Digital X-ray examinations are primarily used for the diagnosis of pathological changes in the lung and the abdominal cavity, to determine the size and shape of the heart, and diseases of the skeletal system. Before any X-ray examination, a doctor well versed in X-ray diagnosis establishes whether the examination is necessary.

The concerned region of the body is usually X-rayed from several directions. This investigation in several projection planes permits better depiction of mutually superimposing structures, which can then be evaluated better.

Fluoroscopy is a special type of digital X-ray investigation by which various motion processes in the body can be viewed directly on a monitor.

How is an X-ray investigation performed?
An X-ray investigation usually takes no more than 5 to 10 minutes, and is entirely devoid of pain.

Before the examination, all foreign bodies in the field of examination, such as watches, jewelry, hair clips or underwired bras are put aside. Highly radiation-sensitive parts of the body are protected with lead aprons.

The patient is then placed in correct position for the examination by trained personnel. To protect themselves from radiation at work, the X-ray staff remain in a different room when the X-ray image is taken.

To obtain clear X-ray images with no motion blur, the patient should not move during the imaging procedure and may need to hold his/her breath briefly if necessary.

In digital X-rays, the radiologist is able to view the images immediately on the computer. The images need not be developed at great cost and effort.

Digital mammography


Mammography is an X-ray investigation by which minimal changes in the tissue structure of the breast can be rendered visible. It is primarily used for breast cancer screening. When breast cancer is detected early, it can be cured in almost all cases.

We perform our investigations exclusively by the digital technique. This is an ultramodern, safe, and very gentle examination technique. Digital mammography works with a markedly lower radiation dose than conventional analog mammography, and provides images of excellent quality.

We are broaching new pathways in breast cancer screening, and rely on fully digital mammography systems which work without an imaging plate. Here we use the revolutionary procedure of fully digital microdose mammography, among other methods. This procedure requires an extremely low radiation dose. Microdose mammography is a difficult balancing act between minimum radiation exposure and best image quality.

Digital techniques permit depiction of the X-ray image on the computer in just a few seconds. Thus, the physician can immediately evaluate the images and establish the diagnosis. Besides, the image can be processed further on the monitor. This improves the evaluation significantly and enhances diagnostic confidence. Rapid and reliable evaluation of the images dispenses entirely with long waiting times for the report.

We give great importance to detailed and competent counseling of our patients, as well as close cooperation with the treating physician. After the examination we inform the patient of the outcome and discuss whether further measures are needed. If yes, we discuss what measures should be performed.

What are the advantages of the examination?
  • Minimal radiation dose and maximal safety
  • Gentle technique
  • Greatest possible diagnostic confidence because of excellent image quality
  • The images can be processed further and magnified on the computer
  • Simple and reliable comparison with older digital images
  • The investigation is pleasant for the patient
  • Short examination time
  • The images can be evaluated rapidly on the computer
  • No need to wait for the outcome of the investigation
How high is the radiation dose?
Several years of investigation have shown that the radiation hazard bears no relationship to the risks ensuing from not performing the investigation. In any case you should undergo a breast screening examination at regular intervals. The benefits of detecting breast cancer early are far greater than the risk of developing cancer due to mammography.

In contrast to analog techniques of mammography, digital mammography employs an electronic imaging plate by which the image data can be stored and evaluated on the computer. This imaging plate is much more radiation-sensitive than an X-ray film.

In conventional analog mammography devices, the breast is imaged on an X-ray film. The radiation exposure per examination is about one tenth of the average natural radiation a person is exposed to every year.

Fully digital mammography goes one step further: instead of an imaging plate it employs a digital radiation detector. It responds with even greater sensitivity to X-rays than the imaging plate. Thus, the required radiation dose is further reduced when performing a fully digital mammography.

In what cases is it meaningful to undergo the examination?
Mammography is mainly performed for breast cancer screening. It is also very useful for the assessment of symptoms and ambiguous findings.

In breast cancer, screening is the most effective means of avoiding an incurable stage of disease. When breast cancer is identified early, the disease can be cured in the majority of cases. The screening examination is performed in women between the ages of 50 and 69 years, in the course of a nation-wide population-based mammography screening program as part of basic medical care. Mammography screening examinations may only be performed at explicitly certified sites.

Do you have symptoms?
Screening mammography is for early detection of breast cancer in women who have no symptoms. If you perceive symptoms such as pain, secretion, or ambiguous findings like a lump in the breast, it is usually more meaningful to use a different procedure. Please consult your gynecologist immediately if you have symptoms, and/or make an appointment during our consultation hours.

No person is obliged to participate in the mammography screening program. There will be no physical contact with a doctor during screening. In other words, the breast will not be inspected or palpated, and you will not receive an ultrasound investigation. A few days after the examination, you will be informed by letter about the outcome of the mammography.

Mammography for breast cancer screening
Mammography is used for breast cancer screening because it permits detection of very small alterations in the tissue structure of the breast - long before a hardening or a lump can be palpated in the breast.

For more information on breast cancer prevention please go to the section entitled Breast cancer screening.

How is the examination performed?
Our experienced physicians take a lot of time for every mammography. In addition to a mammography - if you wish - your breasts will be palpated thoroughly and you will be questioned in detail. You must undress down to the belt for the examination.

Our competent staff members, specially trained in breast diagnosis, will assist you during the examination and will set the device optimally to suit your needs.

A mammography usually takes just a few minutes and is performed in standing position in the majority of cases. The breast is placed between two acrylic glass plates and is pressed very flat from above and below. The flatter the breast is, the more informative the final image will be.

A radiological technologist then prepares two images of each breast. Taking the pictures - from above and from the side - takes just a few seconds each.

The mammography devices can be moved easily and are shaped ergonomically. This enhances the patient‚s comfort while taking the images, and also permits the investigator to place the X-ray detector in various positions. These are important prerequisites for obtaining informative images of high quality.

Besides, the table can be driven so far downward that even patients who undergo a mammography in a wheelchair will find it comfortable.

With the new digital mammography systems, the images can be inspected and evaluated on the monitor immediately after the examination. Thus, you need not wait for the report.

Just a few minutes after the examination we discuss the outcome with you in detail.

What happens after the examination?
After the examination we discuss the outcome with you in detail, as well as any further measures that may be needed. We work closely with your treating physician. We give you the pictures of the investigation immediately for your referring physician; the actual report is then faxed directly to him/her.

In digital mammography, the images can be evaluated a few seconds after the examination by one of our radiologists specialized in breast diagnosis. For your safety we work in accordance with the four-eyes principle. In case of doubt, a colleague is consulted for a second expertise on the outcome of an investigation (second opinion). Because of rapid and reliable evaluation of the images on the computer, you need not wait for the report.

Our doctors give special importance to personal counseling after the examination. Once the images have been evaluated, it is immediately followed by a detailed joint with the doctor, who will explain the images in detail.

An unusual change in the breast, detected on mammography, does not immediately mean that you have breast cancer. A mammography alone does not permit the investigator to establish the type of change with absolute certainty.

Therefore, further investigations are needed to make a reliable diagnosis. For this purpose too, you will be in good hands at our institution.

At all our mammography offices, we offer the option of further investigation of suspicious changes in the breast by ultrasound. For this purpose we have high-resolution ultrasound devices by which various investigations (measurement of tissue density, vascular Doppler examinations) of the breast can be performed.

Sometimes it is necessary to additionally perform magnetic resonance examination imaging (MRI) of the breast, which can be easily performed in our premises at Giesinger Bahnhof or in Radiologie Schwabing.

When these examinations do not provide clear information, a tissue sample will have to be taken and investigated under a microscope. When a so-called punch or vacuum biopsy is needed, we have a specialized team of doctors at our medical offices who perform the intervention by the minimally invasive and tissue-conserving approach. Depending on our specialists‚ estimation these sample biopsies may be taken under ultrasound, mammography, or MRI guidance.

Therapy


In our ultramodern department of radiology, you will be treated with the most recent and gentle diagnostic procedures. In addition, we offer a number of innovative therapy concepts. All treatment measures may only be performed by radiologists and/or specialists in nuclear medicine, because either radiological examination devices like computed tomography are required for such treatment, or because the treatment employs substances that may only be used by nuclear medicine specialists.

Our range of therapy services includes, for instance, pinpointed treatment of back pain.

We take a lot of time for your treatment. Before every treatment we conduct a detailed counseling interview and examine you thoroughly. Our experienced specialists make a careful decision about the most appropriate therapeutic measure in your individual case. To optimize your treatment, we work closely with your treating physician.

Treatment of back pain (facet joint infiltration or periradicular therapy of back pain)
Periradicular therapy or facet joint infiltration is a modern CT-controlled treatment of back pain which permits very precise treatment of pain at the exact site.

Signs of wear in the spine, and especially damage to intervertebral discs, frequently cause severe pain and impairment of mobility; this may significantly limit a person‚s daily life. Some types of pain were difficult to treat in the past - especially pain arising from the irritation of a nerve root.

A modern procedure opens new perspectives in the treatment of back pain. Under computed tomography guidance, analgesic agents and anti-inflammatory medications are injected directly at the site of pain. In periradicular therapy (PRT) it is administered to the affected nerve root, and in facet joint infiltration (FJI) directly to the facet joints.

Periradicular therapy (PRT) is used for local treatment of pain arising from the irritation of a nerve root in the spine (radicular pain). Such irritation is usually caused by a disc prolapse or constriction of the nerve root.

A typical feature of radicular pain is that the cause of pain and the pain response tend to mutually potentiate each other. Inflammation of a nerve root causes specific endogenous substances to be released; these substances cause renewed pain. Thus, the nerve swells again and greater pressure is exerted on the surrounding tissue.

Any therapy used to disrupt the pain spiral must unfold its analgesic and anti-inflammatory effect directly at the site of pain. PRT and FJI are very useful in this regard because they permit very precise treatment of spinal diseases without the need to perform surgery.

Periradicular therapy (PRT) and facet joint infiltration (FJI) may help when a patient has severe and acute pain, and when treatment measures like physiotherapy or drugs have no effect on the patient‚s chronic radiating back pain.

PRT and FJI are able to eliminate the cause of pain in a targeted manner and thus achieve sustained alleviation of symptoms. In some cases it may even serve as a low-risk, gentle and very effective alternative to surgery.

PRT and FJI can be used in the following cases:
  • Acute or chronic back pain of the lumbar, thoracic or cervical spine, originating from an intervertebral disc protrusion or a disc prolapse that presses on a nerve root
  • Pain due to scars after intervertebral disc surgery
  • Radiating pain such as sciatica, lumbago, or pain in the shoulder and arm
  • Pain originating from the sacroiliac joint
  • Inflammation of nerve roots in the cervical, thoracic or lumbar spine
  • Signs of wear in vertebral bodies, such as vertebral slippage
How is PRT or FJI performed?
For periradicular therapy (PRT), an ultrathin injection needle is advanced to the irritated nerve root in the spine; in facet joint infiltration (FJI) it is advanced to the irritated facet joints. The treatment is performed under computed tomography guidance. In other words, a Computed tomography (CT) is performed simultaneously to bring the needle to the correct site.

Highly effective drugs are introduced through this needle. The drugs exert a local anesthetizing as well as an anti-inflammatory effect. The inflammation or pain is usually restricted to a very small area. The optimal view provided by CT permits targeted steering and local administration of the drug accurate to the millimeter. Therefore, a very low dose of medication is required.

The effect is that inflammation and pain are combated very specifically, the inflamed nerve root is calmed, and its swelling reduced. Most of all, the nerve root is relieved and thus the vicious circle of inflammation and potentiation of pain is undermined - which is an important prerequisite for relieving the patient of his/her symptoms.

The treatment is performed with the patient lying on a bed, in local anesthesia, and takes about 5 minutes. No special follow-up treatment is required. You can go home about 30 minutes later and resume your daily routine or work.

Periradicular therapy (PRT) and facet joint infiltration (FJI) act extremely fast. Just after the first treatment some patients experience very noticeable pain relief. If they remain free of symptoms, no further treatment will be necessary. However, patients usually require several treatment sessions at intervals of about 7 days each in order to entirely eradicate the pain.

Both PRT and FJI are associated with high success rates. A significant number of patients experience marked improvement of their symptoms or even complete pain relief.

Screening/Prevention


Many persons assign a number of risk factors to specific diseases like cardiovascular disease or myocardial infarction - without being aware of it. However, a number of diseases can be identified by the use of state-of-the-art imaging procedures even before they cause any symptoms. Thus, they can be treated successfully.

Utilize the modern options of individual screening investigation by doing the following:

Undergo a targeted investigation of one or more organs - for instance in case of known risk factors, or for cancer screening
Undergo investigation in case of ambiguous symptoms or potential signs of an impending or existing disease

Wide spectrum of services for preventive health care
In addition to obtaining evidence of disease, since many years we have been using diagnostic imaging as a screening procedure for various diseases. We offer a number of screening measures:
  • Brain check-up
  • Breast cancer screening
  • Check-up of the heart and vessels
  • Lung check-up for smokers
  • Check-up of the small bowel and the abdominal organs
  • Colorectal cancer screening
  • Investigation of female pelvic organs
  • Investigation of the prostate gland
  • Osteoporosis screening
Examination, counseling and care
We perform all radiological screening examinations with state-of-the-art technology. You will be cared for by highly qualified specialists who adjust every single part of the examination individually to your personal health risk level, and obtain reports very meticulously.

We give great importance to a comprehensive counseling interview in order to explain the results of the investigations in detail and, if necessary, give you competent recommendations for further steps.

Screening and prevention - what is the difference?
Screening examinations provide just a snapshot of the momentary state of a person‚s health. They do not permit any statement about future developments. The emergence of a disease can be identified on time by these investigations, but cannot be prevented. In other words, "genuine prevention" of diseases is not possible, although the two terms are often synonymously. However, the results of the examination can give you valuable suggestions for the prevention of disease, for minimizing the existing health risks and successfully treating diseases.

Comprehensive screening usually requires further steps in addition to the imaging investigation, such as a thorough physical examination or laboratory investigations. Therefore, our screening examinations are always conducted in close cooperation with your referring physician.

Brain check-up

Specific diseases of the brain, such as blood flow disorders, Parkinson‚s disease, or dementia can be investigated early by performing the brain check-up.

The examination is particularly useful for persons with known risk factors for these diseases. For instance, persons with high blood pressure are subject to a high risk of circulatory disorders or strokes.

The examinations are frequently used in persons with ambiguous symptoms, such as forgetfulness, concentration difficulties, dizziness, or headache.

The primary investigation used for a brain check-up is Magnetic resonance imaging (MRI). However, in some cases a brain scintigram may also be performed. Our experienced specialists select the appropriate procedure for you with great care and align each individual step of the investigation individually to your personal health risk.

Breast cancer screening

Breast cancer is the most common type of cancer in women. By performing regular screening examinations, breast cancer is frequently detected at an early point in time when it is not yet palpable for you or your doctor. When diagnosed early, the disease can be treated gently and cured in the majority of cases.

Mammography (X-ray of the breast) is used for breast cancer screening. It is the most widely accepted screening procedure for women who have no symptoms at all.

At our medical offices we perform the examination exclusively in the form of digital mammography - an ultramodern, safe, and very gentle examination technique. For details on digital mammography please go to the section entitled Digital mammography.

Detailed counseling

One of our primary concerns is to advise our patients thoroughly and competently. During our intensive preliminary interview our physician will ask you about any unclear symptoms, pain, any familial predisposition, or previous diseases. When your medical history and the examination provide sufficient indication for the investigation, the physician passes you on to one of our friendly staff members for performing the investigation.

After the investigation you will be informed in detail about the outcome and we will discuss with you the need for further measures. If yes, we will discuss what measures should be performed. If necessary we will also accompany you during the subsequent diagnostic steps. We give great importance to close cooperation with your treating physician.

Background information about breast cancer screening

Cardiovascular check-up

Cardiovascular diseases such as myocardial infarction are the most common cause of death in our part of the world. Many persons are now aware of the risk factors for myocardial infarction. Yet, a person‚s individual risk is not estimated correctly in many cases. Clarifying examinations are performed only when pain in the chest causes a person to seek the advice of a doctor.

Many persons affected by cardiovascular disease experience absolutely no symptoms of their condition over a long period of time. However, today one can visualize even very small changes in blood vessels with the aid of modern examination procedures. Early signs of coronary heart disease include, for instance, calcification of coronary vessels.

Thanks to computed tomography of the heart (cardiac CT) - a new, low-risk, and hardly stressful examination of the heart - calcifications of the coronary vessels can be identified on time and the individual risk of heart attack can be estimated. When the risk is increased, one can counteract the condition by using a variety of preventive and therapeutic measures, and thus reduce the risk of disease.

In addition to cardiac CT, magnetic resonance imaging (MRI) and scintigraphy are the most important screening examinations for cardiovascular disease.

After an intensive preliminary interview about unclear symptoms, pain, familial predisposition or previous diseases, our physicians will decide in each individual case whether a check-up of the cardiovascular system is meaningful and what diagnostic procedure would be indicated.

When is a cardiac CT meaningful?

Coronary heart disease, which leads to constriction, inflammation and calcification in the walls of coronary vessels, is one of the most common causes of a heart attack. In some cases it is manifested as angina pectoris, which is a paroxysmal tightness of the chest or pain behind the breastbone during physical or mental stress. Sometimes such symptoms may cause a heart attack with no previous warning. A few patients with coronary heart disease die due to sudden cardiac death.

In the meantime we know that coronary heart disease is fostered by several risk factors. Important risk factors for coronary heart disease, in addition to age and gender, are the following:
  • High blood pressure
  • Elevated blood fats (especially LDL cholesterol and triglycerides)
  • Diabetes
  • Smoking
  • Stress
  • Obesity
  • Lack of exercise
  • Hereditary factors
Currently, very small calcifications in the coronary vessels can be visualized with the aid of modern imaging procedures such as cardiac CT (computed tomography of the heart) a long time before any symptoms occur. These alterations are found in early phases of coronary heart disease.

Especially persons with one or more risk factors for coronary heart disease, but with no symptoms, will be able to estimate their personal risk of disease and consequent heart attack much more exactly with the aid of this method, which is independent of the previously mentioned risk factors. The determination of coronary calcification on a cardiac CT involves no acute risk and is no additional strain for the patient, except for a small quantity of radiation exposure.

After an intensive preliminary interview about unclear symptoms, familial predisposition or previous diseases, our physicians establish the indication for a cardiac CT individually in each case.

Cardiac CT is not used as a preventive measure alone. Even in patients whose constricted coronary vessels have been dilated with a balloon, or in patients who have undergone bypass surgery, the success of treatment can be controlled by performing a cardiac CT.

Background information on cardiac CT

Lung check-up for smokers

Active smokers are subject to a 12- to 22-fold higher risk of developing bronchial carcinoma (lung cancer) than non-smokers. In Germany, about 50,000 persons die every year due to lung cancer. The earlier a bronchial carcinoma is diagnosed, the greater is the person‚s subsequent life expectancy.

Therefore, we advise active smokers to undergo a lung screening regularly. This also applies to previous smokers during the first ten years of their abstinence. After this time the risk of developing lung cancer is reduced to the level of the normal population. We also advise persons who come into contact with carcinogenic substances at work to undergo this investigation.

If you wish to know how smoking has damaged your lung or your bronchi, you should undergo a lung screening by Computed tomography (CT) and a virtual bronchoscopy to assess the condition of your respiratory tract.

After an intensive preliminary interview about unclear symptoms, pain, familial predisposition or previous diseases, our physicians establish the indication for the examination individually in each case.

Small changes in lung tissue and the pleura can be identified by a lung screening CT investigation. Our state-of-the-art ultrafast multislice computed tomography (CT) devices employ very little radiation in contrast to those of previous generations, and achieve excellent results. The investigation takes just a few minutes.

The bronchi can be investigated by virtual bronchoscopy (which is also based on multislice computed tomography) without the need to insert an instrument into the patient‚s body. Instead of directly examining the bronchi by performing an endoscopy and inserting an endoscope, in virtual bronchoscopy the investigation is "simulated" on the computer. Very small abnormalities in the bronchi can be rendered visible and assessed by this procedure.

Check-up of the intestines and abdominal organs/Screening for intestinal cancer

Thanks to modern imaging procedures, the intestinal tract and the adjoining abdominal organs can be examined rapidly and easily.

An examination of the small bowel with the aid of Magnetic resonance imaging (MRI) primarily helps to demonstrate or investigate inflammatory changes or tumors in patients with unclear symptoms in the upper abdomen. The investigation is painless and involves no radiation exposure because no X-rays are used to produce the images.

Abdominal organs like the liver, the bile ducts, and the pancreas can also be assessed very well with the aid of Magnetic resonance imaging (MRI). If the physician suspects stones or constrictions in the bile ducts or the pancreatic duct, these can be identified without the use of contrast medium and can be localized accurately. Depiction of the kidneys, including the urinary tract, is one of the strengths of MRI and CT.

The large intestines can be investigated rapidly and gently by performing a virtual colonoscopy.

Background information on virtual colonoscopy

Examination of female pelvic organs

In addition to Ultrasonography (ultrasound examination), we use Magnetic resonance imaging (MRI) to detect diseases of the female pelvic organs or locate the cause of unclear symptoms. As no X-rays are used to produce images in MRI, the investigation involves no radiation exposure.

With our ultramodern high-performance devices, we are able to clearly depict and reliably differentiate various types of soft tissues. Thus, we are able to identify sites in the intestines or the pelvic cavity affected by endometriosis. Endometriosis is a benign but frequently painful chronic disease in women, in which endometrial tissue (mucous membranes of the uterus) is found outside the uterine cavity.

Likewise, the cause and severity of renal, urinary tract or bladder disease can be clarified by performing MRI.

Investigation of the prostate gland

Magnetic resonance imaging (MRI) is a useful procedure for prostate cancer screening because very small changes in tissue structure can be identified and assessed reliably by this procedure.

The investigation is entirely painless and involves no radiation exposure because no X-rays are used to produce the images.

Osteoporosis screening

Osteoporosis (bone atrophy) is a common bone disease in which bone calcium levels are reduced. In case of very low bone density, a person is subject to the risk of fracture, spinal curvature deformities, and pain.

Bone density is markedly reduced in women during menopause and in men beyond the age of 50 years. Especially in the presence of other risk factors for osteoporosis, a bone densitometry should be performed to determine the individual‚s personal risk of developing osteoporosis. In case of excessively low bone density, various therapeutic measures can be instituted early to counteract the condition and reduce the risk of disease.

Significant risk factors for the development of osteoporosis include the following:
  • Osteoporosis among close relatives
  • Smoking, heavy alcohol consumption
  • Underweight, malnutrition or vitamin deficiency
  • Too little exercise
  • Prolonged cortisone therapy
  • Various diseases, such as those of the thyroid, the gastrointestinal tract, or the kidney
A so-called bone density measurement (osteodensitometry) is performed to investigate the calcium content and the consequent density and stability of bone, and thus detect osteoporosis early. The measurement of bone density takes just a few minutes, is entirely devoid of pain, and is associated with a very low level of radiation exposure.

After an intensive preliminary interview about unclear symptoms, pain, familial predisposition or previous diseases, our physicians establish the indication for the investigation separately in each individual case.