CT (Computed Tomography)

CT

CT Services

CT (Computed Tomography) is a scan that produces a series of finely cut images capable of detecting a wide range of conditions that do not show or are not easily shown on conventional x-ray.
During the scan, a thin beam of x-rays is focused on the specific part of the body requested by your physician, such as the head, chest, liver, spleen, or spine. The x-ray tube rotates rapidly around you as you lie on the scan table, but does not touch you. Using this rotation, multiple images are obtained as the beam passes through you at many different angles. This creates a cross-sectional image that is picked up by multiple detectors inside the scanner, recorded, and then relayed to a powerful computer. The computer then analyzes the information and constructs very detailed images of the body part in a variety of planes and formats (including 3D).

During certain CT scans, contrast medium may be given to enhance the study. One type is called barium sulfate, which is a thin, white mixture that you drink 30 – 45 minutes before certain abdominal scans. This is used to coat the intestine and allows greater visualization of the small bowel and large intestine. The other contrast medium is an iodine solution (commonly referred to as “dye”) that is given through an IV. This outlines the blood vessels and highlights various organs (e.g., liver, kidneys, spleen, etc.), so they may be more easily seen.

If this contrast is required, and you are 50 years of age or older, a certain blood test may be required to make certain your kidneys are functioning well enough to receive it.

CT (Computed Tomography) studies include:

• Head (Orbits, Sinuses, Facial Bones)
• Soft Tissue Neck
• Spine (Cervical, Lumbar, Thoracic)
• Abdomen and Pelvis
• Chest/CT PE (Pulmonary Embolus Study)
• Upper Extremities (Arms)
• Lower Extremities (Legs)
• Liver/Lung Biopsies
• Urogram (Urological Study)
• CTA (Computed Tomography Angiogram)

Where is the CT Department Located?

At Jackson Hospital in the Imaging Services Department

What is a CTA (Computed Tomography Angiogram) and what does it do?
  • CTA stands for Computed Tomography Angiogram. Though it can be used to describe any CT scan where IV contrast is given during scanning, it usually refers to the scanning of specific vessels after the injection of an Iodine contrast. This allows the Radiologist to quickly identify potential problems with blockages, calcification, stenosis and other vessel abnormalities.
  • These studies include Carotid Angiograms, PE Study (an angiogram of the pulmonary vessels), Angiograms of the Celiac and Messenteric Arteries, Graft Studies and Arterial Run-offs. The images taken are very thin and the timing of the study must be precise, so any request for CTA’s must be specific. For example, you wouldn’t ask for a whole body CTA. The scan process for you, the patient, is not very different from the other exams listed here. For any questions pertaining to a specific CTA study, simply click on the appropriate body part.
Who performs the test?

The exam itself is performed by a Radiologic Technologist RT (R). These technologists are nationally registered with the A.R.R.T. (American Registry of Radiologic Technologists) and licensed through the state of Florida in the use of diagnostic equipment and procedures. Also, the technologist performing your CT scan has additional CT specific training and registration.

Where does it take place?

CT scans are performed in the hospital Imaging Services department.

How long does it take?

However, you may need to allow extra time for each procedure in case of delays or the occasional need for additional images

What you can do to make it a success?
  • Please bring your orders with you when you arrive for your scheduled appointment. Be sure to follow any preparatory instructions you were given.
  • You can help assure a successful, comfortable procedure by carefully following the instructions of your physician, the radiologist and the radiologic technologist. Be sure to answer any questions they may ask about your general health. For example, tell them if you are pregnant, diabetic, and/or have in allergy to foods or medications. Let them know if you have been given the contrast in the past and if you had any side effects. Give them a complete list of medications you may be taking now, including non-prescription medication. Some medications may not be given in conjunction with the contrast. Also, please indicate if you are presently being treated for an infection in any part of your body or are receiving treatments for a condition, such as cancer or dialysis.
What to do before your exam?
  • It is recommended that you wear loose, comfortable clothing for the exam. You will need to remove dentures, glasses, hearing aids, earrings, hairpins and any other object that may be in the path of the x-ray beam. To reduce the risk of valuables being lost, it is recommended that jewelry and pins be removed prior to entering the exam room or simply left at home.
  • If contrast is to be given, you are asked not to eat anything 3-4 hours prior to your exam, or drink anything at least 1 hour prior. This is to insure that in the rare occasion that you become nauseous from the contrast, there is nothing in your stomach that might be brought up and be a choking hazard.
What happens during your exam?
  • Prior to scanning, the CT technologist will screen you for contraindications, such as allergies and renal (kidney) function, to the contrast injection. Pre-contrast laboratory testing may be necessary depending on your renal function and pre-contrast screening. If so, your blood will be drawn and the CT will be performed based on the results of the laboratory tests. You will be asked to lie down on a table attached to the CT scanner. The scanner itself is a large doughnut shaped machine with a large hole in the middle that the table will slide through. Your position on the table depends on the body part being scanned, but a majority of the time you will be asked to lie on your back, with your head on a cushion, with your feet pointing toward the scanner.
  • If you are to receive contrast, the technologist will then start an IV. Once it is in place, they will then take preliminary scans of the area in question. These are called scout images and are used to map the area for testing. During this, you will feel the table move, but you will not be touched. The scanner may, with recorded messages, ask you to take a breath before each scan, and hold it for the duration of the scan (normally 12-13 seconds). For some patients, even this small amount of time is extremely difficult. This is understandable and we will not ask more than you are capable of.
  • Once the technologist completes the scout images, he or she will proceed with the primary exam. If contrast is to be given, it will then be administered through your IV with either a pressure injector or pushed by hand with a syringe, depending on the test. In some patients, the actual injection can be associated with a sensation of warmth, heat or flushing. These feelings are transient and typically pass quickly after the injection.

  • Images will then be obtained. The table will once again move, with the only difference being a slightly longer scan time. It is important that during this scanning you remain as still as possible so that the scanner may get the best possible images. This will help to ensure the most accurate diagnosis possible.
  • When the scans are complete, the table will be positioned out of the scanner and you will be allowed to sit up. If you received an IV, it will be removed and a bandage placed over the injection site. If needed, the technologist will relay any further instructions for you at the time and you’ll be free to leave.
  • The entire procedure normally takes 5-10 minutes. Contrast studies may take an additional 10-15 minutes. If an oral contrast is required, you will also need an additional 45-50 minutes prior to the test.
  • If your physician has asked you to bring the films or disk of your exam with you to your next office visit, please let the technologist know. Please be aware that it may take 20-30 minutes to prepare the images for transfer, so schedule your time accordingly.
What to do after your exam?
  • The Radiologist will review your exam and relay his findings to your physician. This usually takes 1-2 days. In the case of an emergency or life threatening results, your physician will be contacted right away and you will probably be asked to stay with us until he or she is spoken with.
  • Unless you have other tests scheduled, you may resume your previous diet.
What is a Lung/Liver Biopsy and what does it do?
  • A CT-guided needle Biopsy is an invasive procedure that uses CT images and sterile techniques to obtain tissue samples of questionable masses in the lung or liver. Under CT guidance, the Radiologist will insert a biopsy needle into the mass and extract a piece of it that he will then pass on to a Pathologist (a medical doctor who specializes in the diagnosis of disease in blood and tissue) for further study.
  • A CT Guided Biopsy is only done after a consultation with the Radiologist. A CT Scan of the area in question is required prior to any biopsy. This is an invasive procedure. Consent forms are required and specific lab tests are needed on the day of the procedure. For your safety, you will be admitted to the hospital for observation afterward for 2 – 4 hours. Also, your doctor will talk to you about discontinuing certain blood thinners before the exam.
Who performs the test?

The procedure is performed by a Radiologist. A Radiologist is a doctor who specializes in the use of imaging for diagnosis of medical conditions. He is the physician who will do the invasive portion of your test. He will be assisted by a Radiologic Technologist RT(R). These technologists are nationally registered with the A.R.R.T.(American Registry of Radiologic Technologists) and licensed through the state of Florida in the use of diagnostic equipment and procedures. Also, the technologist performing your CT scan has additional CT specific training and registration.

Where does it take place?

CT scans are performed in the hospital Imaging Services department.

How long does it take?

The procedure can take 1-2 hours.

What you can do to make it a success?
  • Please bring your orders with you when you arrive for your scheduled appointment. Be sure to follow any preparatory instructions you were given.
  • You can help ensure a successful, comfortable procedure by carefully following the instructions of your physician, the radiologist, and the radiologic technologist. Be sure to answer any questions they may ask about your general health.
  • Give them a complete list of medications you may be taking now, including non-prescription medication.
What to do before your exam?
  • For a CT Abdomen, it is recommended that you wear loose, comfortable clothing for the exam. You will need to remove dentures, glasses, hearing aids, earrings, hairpins, and any other object that may be in the path of the x-ray beam. To reduce the risk of valuables being lost, it is recommended that jewelry and pins be removed prior to entering the exam room or simply left at home.
What happens during your exam?
  • You will be asked to lie down on a table attached to the CT scanner. The scanner itself is a large doughnut-shaped machine with a large hole in the middle that the table will slide through. Your position on the table depends on the body part being scanned, and which position will allow the greatest access to the mass in question.
  • The technologist will then take preliminary scans of the area in question. These are called scout images and are used to map the area for testing. During this, you will feel the table move, but you will not be touched. The scanner may, with recorded messages, ask you to take a breath before each scan and hold it for the duration of the scan (normally 8-10 seconds). For some patients, even this small amount of time is extremely difficult. This is understandable and we will not ask more than you are capable of.
  • Once the technologist completes the scout images, he or she will place a small plastic grid on the skin. This grid allows us to measure the distance and approach angle to the mass. Another set of images is then taken and the Radiologist uses these pictures to calculate the best pathway to obtain the sample.
  • Once the target area is marked with a felt tip pen, the doctor will then clean it with a topical antiseptic solution and drape the skin with a sterile sheet. A tiny needle is used to administer a local anesthetic. This may feel like a small pinch. Once the spot is thoroughly numb, he will then insert a larger needle. This is called an introducer and will guide the biopsy needle to the precise location. When he is satisfied with the position, he will remove the sliding core from the introducer and insert the biopsy needle. You may feel some pressure from this, but usually no pain. The radiologist will take 2 – 4 samples of tissue and in some cases, a small amount of fluid. Once he is satisfied with the samples, he will remove the needle and apply a bandage to the area. This bandage should stay on for 24 hours, as a precaution against germs.
  • An additional set of images is then taken to insure no complications, and you are then taken to an observation room. You will remain under observation for 2 – 4 hours to insure your well-being and to guard against complications. If there are no complications, you will be discharged at the end of the 2 – 4 hours, with instructions.
What to do after your exam?
  • The tissue sample will be taken to Pathology, where a range of tests will be performed to determine if the mass is benign or malignant and what exactly it is. This may take up to 2 weeks, so contact your physician if you have any concerns.
  • Unless you have other tests scheduled, you may resume your previous diet.
What is a Soft Tissue Neck CT and what does it do?
  • A CT Neck (Soft Tissue) is an exam that takes very thin slice images of the neck, starting from just above the ears and ending just below the clavicles (collar bone). This allows more accurate diagnosis of conditions involving areas such as the nasal passages, mouth, throat, thyroid, and parotid glands.
Who performs the test?

The exam itself is performed by a Radiologic Technologist RT (R). These technologists are nationally registered with the A.R.R.T. (American Registry of Radiologic Technologists) and licensed through the state of Florida in the use of diagnostic equipment and procedures. Also, the technologist performing your CT scan has additional CT-specific training and registration.

Where does it take place?

CT scans are performed in the hospital Imaging Services department.

How long does it take?

CT of the Neck (Soft Tissue) will take approximately 3-5 minutes. If contrast is given, the study could take an additional 10-15 minutes. However, you may need to allow extra time for each procedure in case of delays or the occasional need for additional images.

What you can do to make it a success?

Please bring your orders with you when you arrive for your scheduled appointment. Be sure to follow any preparatory instructions you were given.
You can help ensure a successful, comfortable procedure by carefully following the instructions of your physician, the radiologist, and the radiologic technologist. Be sure to answer any questions they may ask about your general health. For example, tell them if you are pregnant, diabetic, and/or have an allergy to foods or medications. Let them know if you have been given the contrast in the past and if you had any side effects. Give them a complete list of medications you may be taking now, including non-prescription medication. Some medications may not be given in conjunction with the contrast. Also, please indicate if you are presently being treated for an infection in any part of your body or are receiving treatments for a condition, such as cancer or dialysis.

What to do before your exam?

It is recommended that you wear loose, comfortable clothing for the exam. You will need to remove dentures, glasses, hearing aids, earrings, hairpins, and any other object that may be in the path of the x-ray beam. To reduce the risk of valuables being lost, it is recommended that jewelry and pins be removed prior to entering the exam room or simply left at home.

If contrast is to be given, you are asked not to eat anything 3-4 hours prior to your exam, or drink anything at least 1 hour prior. This is to insure that on the rare occasion that you become nauseous from the contrast, there is nothing in your stomach that might be brought up and be a choking hazard.

What happens during your exam?
  • You will be asked to lie down on a table attached to the CT scanner. The scanner itself is a large doughnut-shaped machine with a large hole in the middle that the table will slide through. Your position on the table depends on the body part being scanned, but a majority of the time you will be asked to lie on your back, with your head on a cushion, with your feet pointing toward the scanner.
  • If you are to receive contrast, the technologist will then start an IV. Once it is in place, they will then take preliminary scans of the area in question. These are called scout images and are used to map the area for testing. During this, you will feel the table move, but you will not be touched. The scanner may, with recorded messages, ask you to take a breath before each scan and hold it for the duration of the scan (normally 12-13 seconds). For some patients, even this small amount of time is extremely difficult. This is understandable and we will not ask more than you are capable of.
  • Once the technologist completes the scout images, he or she will proceed with the primary exam. If contrast is to be given, it will then be administered through your IV with either a pressure injector or pushed by hand with a syringe, depending on the test. In some patients, the actual injection can be associated with a sensation of warmth, heat, or flushing. These feelings are transient and typically pass quickly after the injection.
  • Images will then be obtained. The table will once again move, with the only difference being a slightly longer scan time. It is important that during this scanning you remain as still as possible so that the scanner may get the best possible images. This will help to ensure the most accurate diagnosis possible.
  • When the scans are complete, the table will be positioned out of the scanner and you will be allowed to sit up. If you received an IV, it will be removed and a bandage placed over the injection site. If needed, the technologist will relay any further instructions for you at the time and you’ll be free to leave.
  • The entire procedure normally takes 5-10 minutes. Contrast studies may take an additional 10-15 minutes. If an oral contrast is required, you will also need an additional 45-50 minutes prior to the test.
  • If your physician has asked you to bring the films or disk of your exam with you to your next office visit, please let the technologist know. Please be aware that it may take 20-30 minutes to prepare the images for transfer, so schedule your time accordingly.
What to do after your exam?
  • The Radiologist will review your exam and relay his findings to your physician. This usually takes 1-2 days. In the case of an emergency or life threatening results, you physician will be contacted right away and you will probably be asked to stay with us until he or she is spoken with.
  • Unless you have other tests scheduled, you may resume your previous diet.
What is a Cardiac Calcium Scoring CT and what does it do?

A Cardiac Calcium Scoring CT is a noninvasive CT scan performed to detect and measure the severity of cardiac calcifications and coronary artery disease.

Who performs the test?

The exam itself is performed by a Radiologic Technologist RT (R). These technologists are nationally registered with the A.R.R.T. (American Registry of Radiologic Technologists) and licensed through the state of Florida in the use of diagnostic equipment and procedures. Also, the technologist performing your CT scan has additional CT-specific training and registration.

Where does it take place?

CT scans are performed in the hospital Imaging Services department.

How long does it take?

Average person 10 –15 minutes.

What you can do to make it a success?

Be sure to follow any preparatory instructions you were given.
You can help ensure a successful, comfortable procedure by carefully following the instructions of your physician, the radiologist, and the radiologic technologist. Be sure to answer any questions they may ask about your general health. For example, tell them if you are pregnant, diabetic, and/or have an allergy to foods or medications.

What to do before your exam?

It is recommended that you wear loose, comfortable clothing for the exam. To reduce the risk of valuables being lost, it is recommended that jewelry and pins be removed prior to entering the exam room or simply left at home.
No caffeine or strenuous exercise 24 hours prior to your exam.

What happens during your exam?
  • You will be asked to lie down on a table attached to the CT scanner. The scanner itself is a large doughnut shaped machine with a large hole in the middle that the table will slide through. You will lie on your back with your head on a cushion, with your feet pointing toward the scanner. The technologist will apply electrodes (sticky patches) to several areas on your chest that connect to a monitor for measuring your heartrate during the scan.
  • Once these are in place, the technologist will then take preliminary scans of the area in question. These are called scout images and are used to map the area for testing. During this, you will feel the table move, but you will not be touched. The scanner will, with recorded messages, ask you to take a breath before each scan, and hold it for the duration of the scan. For some patients, the amount of time for the breath hold is extremely difficult and we will not ask more than you are capable of.
  • Once the technologist completes the scout images, he or she will proceed with the primary exam. Images will then be obtained. The table will again move, with the only difference being a slightly longer scan time. It is important that during this scanning you remain as still as possible so that the scanner may get the best possible images. This will help to insure the most accurate diagnosis possible.
  • When the scans are complete, the table will be positioned out of the scanner and you will be allowed to sit up.
What to do after your exam?
  • The Radiologist will review your exam and relay his findings to your physician. This usually takes 1-2 days.
What is a CT of the Head, Orbits, Sinuses or Facial Bones and what does it do?
  • A CT of the Head is an exam that takes very thin slice images of the brain, brain stem, and skull. This is useful for the diagnosis of things such as stroke, trauma, congenital defects, bleeding, and possible masses.
  • A CT of the Orbits is an exam that takes very thin slice images of the eyes and orbital socket at three different angles. This allows for the diagnosis of a range of conditions such as injury, disease and congenital defects.
  • A CT of the Sinuses is an exam that takes very thin slice images of all four sinus cavities: frontal, ethmoid, maxillary, and sphenoid. This allows a more accurate diagnosis of conditions such as sinusitis, polyps, deviated septums and congenital defects.
  • A CT of the Facial Bones is an exam that takes very thin slice images of the facial bone structure, including the jaw, nose, eye sockets and cheek bones. These images are helpful in the diagnosis of facial trauma and malformations.
Who performs the test?

The exam itself is performed by a Radiologic Technologist RT(R). These technologists are nationally registered with the A.R.R.T.(American Registry of Radiologic Technologists) and licensed through the state of Florida in the use of diagnostic equipment and procedures. Also, the technologist performing your CT scan has additional CT specific training and registration.

Where does it take place?

CT scans are performed in the hospital Imaging Services department.

How long does it take?

A CT of the Head/Orbits/Sinuses/Facial Bones will take approximately 3-5 minutes. If contrast is given, the study could take an additional 10-15 minutes. However, you may need to allow extra time for each procedure in case of delays or the occasional need for additional images

What you can do to make it a success?

A CT scan is usually painless. The machine does not touch you and you do not feel the x-rays. Occasionally, a contrast may be given to enhance the study. For a CT Head, this is in the form of an IV injection of an iodine solution. In some patients, the actual injection can be associated with a sensation of warmth, heat or flushing. These feelings are transient and typically pass quickly after the injection.

You can help assure a successful, comfortable procedure by carefully following the instructions of your physician, the radiologist and the radiologic technologist. Be sure to answer any questions they may ask about your general health. For example, tell them if you are pregnant, diabetic, and/or have in allergy to foods or medications. Let them know if you have been given the contrast in the past and if you had any side effects. Give them a complete list of medications you may be taking now, including non-prescription medication. Some medications may not be given in conjunction with the contrast. Also, please indicate if you are presently being treated for an infection in any part of your body or are receiving treatments for a condition, such as cancer or dialysis.

What to do before your exam?

For a CT of the Head/Orbits/Sinuses/Facial Bones, it is recommended that you wear loose, comfortable clothing for the exam. You will need to remove dentures, glasses, hearing aids, earrings, hairpins and any other object that may be in the path of the x-ray beam. . To reduce the risk of valuables being lost, it is recommended that hair pins, jewelry and other valuables be removed prior to entering the exam room or simply left at home.

If contrast is to be given, you are asked not to eat anything 3-4 hours prior to your exam, or drink anything at least 1 hour prior. This is to insure that nothing is in your stomach should you become nauseous from the contrast.

What happens during your exam?

For CT Head/Orbits/Sinuses/Facial Bones, you will be asked to lie down on a table attached to the CT scanner. The scanner itself is a large doughnut shaped machine with a large hole in the middle that the table will slide through. Your position on the table depends on the body part being scanned, but a majority of the time you will be asked to lie on your back, with your head on a cushion, with your head pointing toward the scanner. If you are to receive contrast, the technologist will then start an IV. Once it is in place, they will then take preliminary scans of the area in question. These are called scout images and are used to map the area for testing. During this, you will feel the table move, but you will not be touched. Once the technologist completes the scout images, he or she will proceed with the primary exam. If contrast is to be given, it will then be administered through your IV with either a pressure injector or pushed by hand with a syringe, depending on the test. In some patients, the actual injection can be associated with a sensation of warmth, heat, or flushing. These feelings are transient and typically pass quickly after the injection.

Images will then be obtained. The table will once again move, with the only difference being a slightly longer scan time. It is important that during this scanning you remain as still as possible so that the scanner may get the best possible images. This will help to ensure the most accurate diagnosis possible. When the scans are complete, the table will be positioned out of the scanner and you will be allowed to sit up. If you received an IV, it will be removed and a bandage placed over the injection site. If needed, the technologist will relay any further instructions for you at the time and you’ll be free to leave.

What to do after your exam?

The Radiologist will review your exam and relay his findings to your physician. This usually takes 1-2 days. In the case of an emergency or life-threatening results, your physician will be contacted right away and you will probably be asked to stay with us until he or she is spoken with.

What is a CT of the Upper Extremity and what does it do?

A CT of the Upper Extremity is an exam that takes very thin slice images of a specified portion of your arm(s), from the shoulder girdle to the tips of your fingers. These are far more detailed than plain x-rays and allow imaging in a range of different angles as well as 3D reformation. This allows more accurate diagnosis of things such as fractures, dislocations, and other injuries or conditions.

Who performs the test?

The exam itself is performed by a Radiologic Technologist RT (R). These technologists are nationally registered with the A.R.R.T. (American Registry of Radiologic Technologists) and licensed through the state of Florida in the use of diagnostic equipment and procedures. Also, the technologist performing your CT scan has additional CT specific training and registration.

Where does it take place?

CT scans are performed in the hospital Imaging Services department.

How long does it take?

An Upper Extremity CT takes about 5-10 minutes.
However, you may need to allow extra time for each procedure in case of delays or the occasional need for additional images

What you can do to make it a success?
  • Please bring your orders with you when you arrive for your scheduled appointment. Be sure to follow any preparatory instructions you were given.
  • You can help ensure a successful, comfortable procedure by carefully following the instructions of your physician, the radiologist and the radiologic technologist. Be sure to answer any questions they may ask about your general health. For example, tell them if you are pregnant, diabetic, and/or have an allergy to foods or medications. Let them know if you have been given the contrast in the past and if you had any side effects. Give them a complete list of medications you may be taking now, including non-prescription medication. Some medications may not be given in conjunction with the contrast. Also, please indicate if you are presently being treated for an infection in any part of your body or are receiving treatments for a condition, such as cancer or dialysis.
What to do before your exam?
  • It is recommended that you wear loose, comfortable clothing for the exam. You will need to remove dentures, glasses, hearing aids, earrings, hairpins and any other object that may be in the path of the x-ray beam. To reduce the risk of valuables being lost, it is recommended that jewelry and pins be removed prior to entering the exam room or simply left at home.
  • If contrast is to be given, you are asked not to eat anything 3-4 hours prior to your exam, or drink anything at least 1 hour prior. This is to insure that on the rare occasion that you become nauseous from the contrast, there is nothing in your stomach that might be brought up and be a choking hazard.
  • To reduce radiation, the Upper Extremity is normally not scanned entirely, but rather at a specified point of interest along the extremity. It is recommended that X-rays are done prior to scanning in order to identify the problem area. If prior x-rays were done at another facility, please bring a copy of them with you when you come for your CT appointment.
What happens during your exam?
  • You will be asked to lie down on a table attached to the CT scanner. The scanner itself is a large doughnut shaped machine with a large hole in the middle that the table will slide through. Your position on the table depends on the body part being scanned, but a majority of the time you will be asked to lie on your back, with your head on a cushion, with your feet pointing toward the scanner.
  • If you are to receive contrast, the technologist will then start an IV. Once it is in place, they will then take preliminary scans of the area in question. These are called scout images and are used to map the area for testing. During this, you will feel the table move, but you will not be touched. The scanner may, with recorded messages, ask you to take a breath before each scan, and hold it for the duration of the scan (normally 12-13 seconds). For some patients, even this small amount of time is extremely difficult. This is understandable and we will not ask more than you are capable of.
  • Once the technologist completes the scout images, he or she will proceed with the primary exam. If contrast is to be given, it will then be administered through your IV with either a pressure injector or pushed by hand with a syringe, depending on the test. In some patients, the actual injection can be associated with a sensation of warmth, heat or flushing. These feelings are transient and typically pass quickly after the injection.
  • Images will then be obtained. The table will once again move, with the only difference being a slightly longer scan time. It is important that during this scanning you remain as still as possible so that the scanner may get the best possible images. This will help to ensure the most accurate diagnosis possible.
  • When the scans are complete, the table will be positioned out of the scanner and you will be allowed to sit up. If you received an IV, it will be removed and a bandage placed over the injection site. If needed, the technologist will relay any further instructions for you at the time and you’ll be free to leave.
  • The entire procedure normally takes 5-10 minutes. Contrast studies may take an additional 10-15 minutes. If an oral contrast is required, you will also need an additional 45-50 minutes prior to the test.
  • If your physician has asked you to bring the films or disk of your exam with you to your next office visit, please let the technologist know. Please be aware that it may take 20-30 minutes to prepare the images for transfer, so schedule your time accordingly.
What to do after your exam?
  • The Radiologist will review your exam and relay his findings to your physician. This usually takes 1-2 days. In the case of an emergency or life threatening results, you physician will be contacted right away and you will probably be asked to stay with us until he or she is spoken with.
  • Unless you have other tests scheduled, you may resume your previous diet.
What is a CT of the Chest and what does it do?
  • A CT Chest is an examination that takes very thin slice pictures of the chest cavity. The images start just above the shoulders and end at the top of your kidneys. The areas included in the study are the heart, lungs, and great vessels, as well as portions of the thyroid, liver, esophagus, and stomach.
  • A CT PE (Pulmonary Embolus) Study is a CT exam of the chest that uses a combination of high-speed CT imaging and an Iodine contrast to make very thin and very detailed pictures of the pulmonary artery and vein. This is done in order to determine if any clots (pulmonary emboli) are present in these lung vessels and is a valuable tool in the diagnosis and subsequent treatment of this condition.
  • Doctors use chest CT scans to:
    • Show the size, shape, and position of your lungs and other structures in your chest.
    • Follow up on abnormal findings from standard chest x-rays.
    • Find the cause of lung symptoms, such as shortness of breath or chest pain.
    • Find out whether you have a lung problem, such as a tumor, excess fluid around the lungs, or a pulmonary embolism (a blood clot in the lungs). The test also is used to check for other conditions, such as tuberculosis (tu-ber-kyu-LO-sis), emphysema (em-fi-SE-ma), and pneumonia (nu-MO-ne-ah).
Who performs the test?

The exam itself is performed by a Radiologic Technologist RT (R). These technologists are nationally registered with the A.R.R.T. (American Registry of Radiologic Technologists) and licensed through the state of Florida in the use of diagnostic equipment and procedures. Also, the technologist performing your CT scan has additional CT specific training and registration.

Where does it take place?

CT scans are performed in the hospital Imaging Services department.

How long does it take?

A CT of the Chest will take approximately 5-10 minutes. If contrast is given, the study could take an additional 10-15 minutes. However, you may need to allow extra time for each procedure in case of delays or the occasional need for additional images

What you can do to make it a success?

Please bring your orders with you when you arrive for your scheduled appointment. Be sure to follow any preparatory instructions you were given.
You can help assure a successful, comfortable procedure by carefully following the instructions of your physician, the radiologist and the radiologic technologist. Be sure to answer any questions they may ask about your general health. For example, tell them if you are pregnant, diabetic, and/or have in allergy to foods or medications. Let them know if you have been given the contrast in the past and if you had any side effects. For a CT PE Study or CT Chest ordered with contrast, IV contrast must be given. This is in the form of an IV injection of an iodine solution. In some patients, the actual injection can be associated with a sensation of warmth, heat or flushing. These feelings are transient and typically pass quickly after the injection.

Give them a complete list of medications you may be taking now, including non-prescription medication. Some medications may not be given in conjunction with the contrast. Also, please indicate if you are presently being treated for an infection in any part of your body or are receiving treatments for a condition, such as cancer or dialysis.

What to do before your exam?

It is recommended that you wear loose, comfortable clothing for the exam. You will need to remove dentures, glasses, hearing aids, earrings, hairpins, and any other object that may be in the path of the x-ray beam. To reduce the risk of valuables being lost, it is recommended that jewelry and pins be removed prior to entering the exam room or simply left at home.

If contrast is to be given, you are asked not to eat anything 3-4 hours prior to your exam, or drink anything at least 1 hour prior. This is to insure that in the rare occasion that you become nauseous from the contrast, there is nothing in your stomach that might be brought up and be a choking hazard.

 *For a CT PE Study or CT Chest ordered with contrast, IV contrast must be given. This is in the form of an IV injection of an iodine solution. In some patients, the actual injection can be associated with a sensation of warmth, heat or flushing. These feelings are transient and typically pass quickly after the injection.

What happens during your exam?

You will be asked to lie down on a table attached to the CT scanner. The scanner itself is a large doughnut shaped machine with a large hole in the middle that the table will slide through. Your position on the table depends on the body part being scanned, but a majority of the time you will be asked to lie on your back, with your head on a cushion, with your feet pointing toward the scanner.

If you are to receive contrast, the technologist will then start an IV. Once it is in place, they will then take preliminary scans of the area in question. These are called scout images and are used to map the area for testing. During this, you will feel the table move, but you will not be touched. The scanner may, with recorded messages, ask you to take a breath before each scan, and hold it for the duration of the scan (normally 12-13 seconds). For some patients, even this small amount of time is extremely difficult. This is understandable and we will not ask more than you are capable of.

Once the technologist completes the scout images, he or she will proceed with the primary exam. If contrast is to be given, it will then be administered through your IV with either a pressure injector.

*For a CT PE Study or CT Chest ordered with contrast, IV contrast must be given. This is in the form of an IV injection of an iodine solution. In some patients, the actual injection can be associated with a sensation of warmth, heat or flushing. These feelings are transient and typically pass quickly after the injection.

Images will then be obtained. The table will once again move, with the only difference being a slightly longer scan time. It is important that during this scanning you remain as still as possible so that the scanner may get the best possible images. This will help to ensure the most accurate diagnosis possible.

When the scans are complete, the table will be positioned out of the scanner and you will be allowed to sit up. If you received an IV, it will be removed and a bandage placed over the injection site. If needed, the technologist will relay any further instructions for you at the time and you’ll be free to leave.

  • The entire procedure normally takes 5-10 minutes. Contrast studies may take an additional 10-15 minutes. If an oral contrast is required, you will also need an additional 45-50 minutes prior to the test.
  • After a PE Study, you will be asked to wait in our waiting room until a report can be given to your physician. The only exception is if following specific orders from your doctor to return to their office or wait elsewhere.

  • If your physician has asked you to bring the films or disk of your exam with you to your next office visit, please let the technologist know. Please be aware that it may take 20-30 minutes to prepare the images for transfer, so schedule your time accordingly.

What to do after your exam?
  • The Radiologist will review your exam and relay his findings to your physician. This usually takes 1-2 days. In the case of an emergency or life threatening results, you physician will be contacted right away and you will probably be asked to stay with us until he or she is spoken with.
  • After a PE Study, you will be asked to wait in our waiting room until a report can be given to your physician. The only exception is if following specific orders from your doctor to return to their office or wait elsewhere.

  • Unless you have other tests scheduled, you may resume your previous diet.
What is a CT of the Spine and what does it do?

A CT of the Lumbar, Cervical or Thoracic Spine takes very thin slice images of the lumbar spine and spinal canal. These images are an important tool for the Radiologist in the diagnosis of fractures, misalignments, and disk malformations.

Who performs the test?

The exam itself is performed by a Radiologic Technologist RT (R). These technologists are nationally registered with the A.R.R.T. (American Registry of Radiologic Technologists) and licensed through the state of Florida in the use of diagnostic equipment and procedures. Also, the technologist performing your CT scan has additional CT specific training and registration.

Where does it take place?

CT scans are performed in the hospital Imaging Services department.

How long does it take?

A CT of the Lumbar, Cervical or Thoracic Spine will take approximately 5-10 minutes.
However, you may need to allow extra time for each procedure in case of delays or the occasional need for additional images

What you can do to make it a success?
  • Please bring your orders with you when you arrive for your scheduled appointment. Be sure to follow any preparatory instructions you were given.
    You can help assure a successful, comfortable procedure by carefully following the instructions of your physician, the radiologist and the radiologic technologist. Be sure to answer any questions they may ask about your general health. For example, tell them if you are pregnant, diabetic, and/or have in allergy to foods or medications. Let them know if you have been given the contrast in the past and if you had any side effects. Give them a complete list of medications you may be taking now, including non-prescription medication. Some medications may not be given in conjunction with the contrast. Also, please indicate if you are presently being treated for an infection in any part of your body or are receiving treatments for a condition, such as cancer or dialysis.
What to do before your exam?
  • It is recommended that you wear loose, comfortable clothing for the exam. You will need to remove dentures, glasses, hearing aids, earrings, hairpins and any other object that may be in the path of the x-ray beam. To reduce the risk of valuables being lost, it is recommended that jewelry and pins be removed prior to entering the exam room or simply left at home.
  • If contrast is to be given, you are asked not to eat anything 3-4 hours prior to your exam, or drink anything at least 1 hour prior. This is to insure that in the rare occasion that you become nauseous from the contrast, there is nothing in your stomach that might be brought up and be a choking hazard.
What happens during your exam?
  • You will be asked to lie down on a table attached to the CT scanner. The scanner itself is a large doughnut shaped machine with a large hole in the middle that the table will slide through. Your position on the table depends on the body part being scanned, but a majority of the time you will be asked to lie on your back, with your head on a cushion, with your feet pointing toward the scanner.
  • If you are to receive contrast, the technologist will then start an IV. Once it is in place, they will then take preliminary scans of the area in question. These are called scout images and are used to map the area for testing. During this, you will feel the table move, but you will not be touched. The scanner may, with recorded messages, ask you to take a breath before each scan, and hold it for the duration of the scan (normally 12-13 seconds). For some patients, even this small amount of time is extremely difficult. This is understandable and we will not ask more than you are capable of.
  • Once the technologist completes the scout images, he or she will proceed with the primary exam. If contrast is to be given, it will then be administered through your IV with either a pressure injector or pushed by hand with a syringe, depending on the test. In some patients, the actual injection can be associated with a sensation of warmth, heat or flushing. These feelings are transient and typically pass quickly after the injection.
  • Images will then be obtained. The table will once again move, with the only difference being a slightly longer scan time. It is important that during this scanning you remain as still as possible so that the scanner may get the best possible images. This will help to insure the most accurate diagnosis possible.
  • When the scans are complete, the table will be positioned out of the scanner and you will be allowed to sit up. If you received an IV, it will be removed and a bandage placed over the injection site. If needed, the technologist will relay any further instructions for you at the time and you’ll be free to leave.
  • The entire procedure normally takes 5-10 minutes. Contrast studies may take an additional 10-15 minutes. If an oral contrast is required, you will also need an additional 45-50 minutes prior to the test.
  • If your physician has asked you to bring the films or disk of your exam with you to your next office visit, please let the technologist know. Please be aware that it may take 20-30 minutes to prepare the images for transfer, so schedule your time accordingly.
What to do after your exam?
  • The Radiologist will review your exam and relay his findings to your physician. This usually takes 1-2 days. In the case of an emergency or life-threatening results, your physician will be contacted right away and you will probably be asked to stay with us until he or she is spoken with.
  • Unless you have other tests scheduled, you may resume your previous diet.
What is a CT of the Abdomen/Pelvis and what does it do?

A CT of the Abdomen is an examination that takes very thin slice pictures of the upper abdomen. The images start just above the liver and end at the navel. The areas included in the study are the liver, pancreas, stomach, spleen, kidneys, adrenal glands, and the top portions of the small and large intestines.

A CT of the Pelvis is an examination that takes very thin slice pictures of the lower abdomen and pelvis. The images start just above the navel and end just below the groin. The areas included in the study are the lower portions of the small and large intestines, sigmoid colon, bladder and, in men, the prostate.

Who performs the test?

The exam itself is performed by a Radiologic Technologist RT (R). These technologists are nationally registered with the A.R.R.T. (American Registry of Radiologic Technologists) and licensed through the state of Florida in the use of diagnostic equipment and procedures. Also, the technologist performing your CT scan has additional CT specific training and registration.

Where does it take place?

CT scans are performed in the hospital Imaging Services department.

How long does it take?

Average person 5-10 minutes. If contrast is given, it could take 20-30 minutes.

What you can do to make it a success?
  • Please bring your orders with you when you arrive for your scheduled appointment. Be sure to follow any preparatory instructions you were given.
    You can help assure a successful, comfortable procedure by carefully following the instructions of your physician, the radiologist and the radiologic technologist. Be sure to answer any questions they may ask about your general health. For example, tell them if you are pregnant, diabetic, and/or have in allergy to foods or medications. Let them know if you have been given the contrast in the past and if you had any side effects. Give them a complete list of medications you may be taking now, including non-prescription medication. Some medications may not be given in conjunction with the contrast. Also, please indicate if you are presently being treated for an infection in any part of your body or are receiving treatments for a condition, such as cancer or dialysis.
What to do before your exam?
  • It is recommended that you wear loose, comfortable clothing for the exam. You will need to remove dentures, glasses, hearing aids, earrings, hairpins and any other object that may be in the path of the x-ray beam. To reduce the risk of valuables being lost, it is recommended that jewelry and pins be removed prior to entering the exam room or simply left at home.
  • If contrast is to be given, you are asked not to eat anything 3-4 hours prior to your exam, or drink anything at least 1 hour prior. This is to insure that in the rare occasion that you become nauseous from the contrast, there is nothing in your stomach that might be brought up and be a choking hazard.
What happens during your exam?
  • You will be asked to lie down on a table attached to the CT scanner. The scanner itself is a large doughnut shaped machine with a large hole in the middle that the table will slide through. Your position on the table depends on the body part being scanned, but a majority of the time you will be asked to lie on your back, with your head on a cushion, with your feet pointing toward the scanner.
  • If you are to receive contrast, the technologist will then start an IV. Once it is in place, they will then take preliminary scans of the area in question. These are called scout images and are used to map the area for testing. During this, you will feel the table move, but you will not be touched. The scanner may, with recorded messages, ask you to take a breath before each scan, and hold it for the duration of the scan (normally 12-13 seconds). For some patients, even this small amount of time is extremely difficult. This is understandable and we will not ask more than you are capable of.
  • Once the technologist completes the scout images, he or she will proceed with the primary exam. If contrast is to be given, it will then be administered through your IV with either a pressure injector or pushed by hand with a syringe, depending on the test. . In some patients, the actual injection can be associated with a sensation of warmth, heat or flushing. These feelings are transient and typically pass quickly after the injection.
  • Images will then be obtained. The table will once again move, with the only difference being a slightly longer scan time. It is important that during this scanning you remain as still as possible so that the scanner may get the best possible images. This will help to insure the most accurate diagnosis possible.
  • When the scans are complete, the table will be positioned out of the scanner and you will be allowed to sit up. If you received an IV, it will be removed and a bandage placed over the injection site. If needed, the technologist will relay any further instructions for you at the time and you’ll be free to leave.
  • The entire procedure normally takes 5-10 minutes. Contrast studies may take an additional 10-15 minutes. If an oral contrast is required, you will also need an additional 45-50 minutes prior to the test.
  • If your physician has asked you to bring the films or disk of your exam with you to your next office visit, please let the technologist know. Please be aware that it may take 20-30 minutes to prepare the images for transfer, so schedule your time accordingly.
What to do after your exam?
  • The Radiologist will review your exam and relay his findings to your physician. This usually takes 1-2 days. In the case of an emergency or life threatening results, you physician will be contacted right away and you will probably be asked to stay with us until he or she is spoken with.
    Unless you have other tests scheduled, you may resume your previous diet.
What is a CT Urogram and what does it do?

A CT Urogram is a CT exam that takes very thin slice images of the urinary system, starting just above the kidneys and ending just below the pubic bone. This allows accurate visualization of the kidneys, ureters, bladder, and urethra, which in turn allows a more accurate diagnosis of urinary conditions such as stones, blockages, kidney and bladder disease, and prostate issues.

Who performs the test?

The exam itself is performed by a Radiologic Technologist RT(R). These technologists are nationally registered with the A.R.R.T. (American Registry of Radiologic Technologists) and licensed through the state of Florida in the use of diagnostic equipment and procedures. Also, the technologist performing your CT scan has additional CT specific training and registration.

Where does it take place?

CT scans are performed in the hospital Imaging Services department.

How long does it take?

A CT Urogram will take approximately 5-10 minutes. However, you may need to allow extra time for each procedure in case of delays or the occasional need for additional images

What you can do to make it a success?
  • Please bring your orders with you when you arrive for your scheduled appointment. Be sure to follow any preparatory instructions you were given.
    You can help assure a successful, comfortable procedure by carefully following the instructions of your physician, the radiologist and the radiologic technologist. Be sure to answer any questions they may ask about your general health. For example, tell them if you are pregnant, diabetic, and/or have in allergy to foods or medications.
  • Give them a complete list of medications you may be taking now, including non-prescription medication. .
What to do before your exam?
  • It is recommended that you wear loose, comfortable clothing for the exam. You will need to remove dentures, glasses, hearing aids, earrings, hairpins and any other object that may be in the path of the x-ray beam. To reduce the risk of valuables being lost, it is recommended that hair pins, jewelry and other valuables be removed prior to entering the exam room or simply left at home.
What happens during your exam?
  • You will be asked to lie down on a table attached to the CT scanner. The scanner itself is a large doughnut shaped machine with a large hole in the middle that the table will slide through. Your position on the table depends on the body part being scanned, but a majority of the time you will be asked to lie on your back, with your head on a cushion, with your feet pointing toward the scanner.
  • If you are to receive contrast, the technologist will then start an IV. Once it is in place, they will then take preliminary scans of the area in question. These are called scout images and are used to map the area for testing. During this, you will feel the table move, but you will not be touched. The scanner may, with recorded messages, ask you to take a breath before each scan, and hold it for the duration of the scan (normally 12-13 seconds). For some patients, even this small amount of time is extremely difficult. This is understandable and we will not ask more than you are capable of.
  • Once the technologist completes the scout images, he or she will proceed with the primary exam. If contrast is to be given, it will then be administered through your IV with either a pressure injector or pushed by hand with a syringe, depending on the test. Images will then be obtained. The table will once again move, with the only difference being a slightly longer scan time. It is important that during this scanning you remain as still as possible so that the scanner may get the best possible images. This will help to ensure the most accurate diagnosis possible.
  • When the scans are complete, the table will be positioned out of the scanner and you will be allowed to sit up. If you received an IV, it will be removed and a bandage placed over the injection site. If needed, the technologist will relay any further instructions for you at the time and you’ll be free to leave.
  • The entire procedure normally takes 5-10 minutes. Contrast studies may take an additional 10-15 minutes. If an oral contrast is required, you will also need an additional 45-50 minutes prior to the test.
  • If your physician has asked you to bring the films or disk of your exam with you to your next office visit, please let the technologist know. Please be aware that it may take 20-30 minutes to prepare the images for transfer, so schedule your time accordingly.
What to do after your exam?
  • The Radiologist will review your exam and relay his findings to your physician. This usually takes 1-2 days. In the case of an emergency or life-threatening results, your physician will be contacted right away and you will probably be asked to stay with us until he or she is spoken with.
  • Unless you have other tests scheduled, you may resume your previous diet.

What is a Lower Extremity CT and What does it do?

A CT of the Lower Extremities is an exam that takes very thin slice images of a specified portion of your leg(s), from the hip joint to the tips of your toes. These are far more detailed than plain x-rays and allow imaging in range of different angles as well as 3D reformation. This allows more accurate diagnosis of things such as fractures, dislocations, and other injuries or conditions.

Who performs the test?

The exam itself is performed by a Radiologic Technologist RT (R). These technologists are nationally registered with the A.R.R.T. (American Registry of Radiologic Technologists) and licensed through the state of Florida in the use of diagnostic equipment and procedures. Also, the technologist performing your CT scan has additional CT specific training and registration.

Where does it take place?

Ct scans are performed in the hospital Imaging Services department.

How long does it take?

A Lower Extremity CT will take approximately 3-5 minutes. If contrast is given, the study could take an additional 10-15 minutes. However, you may need to allow extra time for each procedure in case of delays or the occasional need for additional images.

What you can do to make it a success?

Please bring your orders with you when you arrive for your scheduled appointment. Be sure to follow any preparatory instructions you were given.
You can help assure a successful, comfortable procedure by carefully following the instructions of your physician, the radiologist and the radiologic technologist. Be sure to answer any questions they may ask about your general health. For example, tell them if you are pregnant, diabetic, and/or have in allergy to foods or medications. Let them know if you have been given the contrast in the past and if you had any side effects. Give them a complete list of medications you may be taking now, including non-prescription medication. Some medications may not be given in conjunction with the contrast. Also, please indicate if you are presently being treated for an infection in any part of your body or are receiving treatments for a condition, such as cancer or dialysis.

What to do before your exam?
  • It is recommended that you wear loose, comfortable clothing for the exam. You will need to remove dentures, glasses, hearing aids, earrings, hairpins and any other object that may be in the path of the x-ray beam. To reduce the risk of valuables being lost, it is recommended that jewelry and pins be removed prior to entering the exam room or simply left at home.
  • If contrast is to be given, you are asked not to eat anything 3-4 hours prior to your exam, or drink anything at least 1 hour prior. This is to insure that in the rare occasion that you become nauseous from the contrast, there is nothing in your stomach that might be brought up and be a choking hazard.
  • To reduce radiation, the Lower Extremity is normally not scanned entirely, but rather at a specified point of interest along the extremity. It is recommended that x-rays are done prior to scanning in order to identify the problem area. If prior x-rays were done at another facility, please bring a copy of them with you when you come for your CT appointment.
What happens during your exam?
  • You will be asked to lie down on a table attached to the CT scanner. The scanner itself is a large doughnut shaped machine with a large hole in the middle that the table will slide through. Your position on the table depends on the body part being scanned, but a majority of the time you will be asked to lie on your back, with your head on a cushion, with your feet pointing toward the scanner.
  • If you are to receive contrast, the technologist will then start an IV. Once it is in place, they will then take preliminary scans of the area in question. These are called scout images and are used to map the area for testing. During this, you will feel the table move, but you will not be touched. The scanner may, with recorded messages, ask you to take a breath before each scan, and hold it for the duration of the scan (normally 12-13 seconds). For some patients, even this small amount of time is extremely difficult. This is understandable and we will not ask more than you are capable of.
  • Once the technologist completes the scout images, he or she will proceed with the primary exam. If contrast is to be given, it will then be administered through your IV with either a pressure injector or pushed by hand with a syringe, depending on the test. In some patients, the actual injection can be associated with a sensation of warmth, heat or flushing. These feelings are transient and typically pass quickly after the injection.
  • Images will then be obtained. The table will once again move, with the only difference being a slightly longer scan time. It is important that during this scanning you remain as still as possible so that the scanner may get the best possible images. This will help to insure the most accurate diagnosis possible.
  • When the scans are complete, the table will be positioned out of the scanner and you will be allowed to sit up. If you received an IV, it will be removed and a bandage placed over the injection site. If needed, the technologist will relay any further instructions for you at the time and you’ll be free to leave.
  • The entire procedure normally takes 5-10 minutes. Contrast studies may take an additional 10-15 minutes. If an oral contrast is required, you will also need an additional 45-50 minutes prior to the test.
  • If your physician has asked you to bring the films or disk of your exam with you to your next office visit, please let the technologist know. Please be aware that it may take 20-30 minutes to prepare the images for transfer, so schedule your time accordingly.
What to do after your exam?
  • The Radiologist will review your exam and relay his findings to your physician. This usually takes 1-2 days. In the case of an emergency or life threatening results, you physician will be contacted right away and you will probably be asked to stay with us until he or she is spoken with.
  • Unless you have other tests scheduled, you may resume your previous diet.
What is a CT-Guided Tissue Biopsy and What Does It Do?

A CT-guided tissue biopsy is a minimally invasive procedure that uses computed tomography (CT) imaging to help guide a needle precisely to a suspicious area for tissue sampling. The tissue sample is then analyzed under a microscope to check for diseases such as infections, inflammation, or cancer.

Types of CT-Guided Tissue Biopsies
  • Fine-Needle Aspiration (FNA): A thin needle is used to withdraw small amounts of fluid or cells from the target tissue.
  • Core Needle Biopsy (CNB): A larger, hollow needle removes a small, solid piece of tissue for more detailed examination.
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