The incredible view behind our CTs, MRIs

Spend some time talking with radiologist Maheen Rajput, MD, about diagnostic scans, and there’s a good chance she’ll not only mention the state-of-the art technology at UI Hospitals & Clinics, but also our highly trained technologists.

Whether it’s finding an unexpected pulmonary embolism, creating 3D models prior to surgery, or identifying whether more chemotherapy is needed, radiology, she says, is the window into the patient.

Rajput recently shared how diagnostic scans like computerized tomography (CT) and magnetic resonance imaging (MRI) provide an important piece of the puzzle to help guide clinicians, and why it’s often beneficial for our patients to have their scans done in-house.

Why did you choose to work in radiology?

“Imaging plays an important part in determining if a patient should have another procedure or surgery, or helping to guide surgery. My role is to provide the best read that I can for patients that I’m taking care of. We’re the window into the patient.” 

The pictures of the lungs on the screen are amazing. What are we seeing?

“Our department is very committed to having cutting-edge imaging. We’re looking at the perfusion of the lungs in addition to how they’re aerated. The 3D models show defects where the lung isn’t being perfused appropriately to help diagnose pulmonary embolism in patients.

Not only are our CT scanners fast, but they allow you to really manipulate the primary data and to display it in ways like the 3D models. It’s really helpful for surgeons planning orthopedic surgery or neurosurgery. They can understand that 3D model and apply it to what they’re seeing in the operating room. While we’ve been doing this for a long time, there are different ways we’re doing it now that are really more cutting edge.

“Some of the benefits of being at an academic center like University of Iowa Health Care is the multidisciplinary approach to taking care of a patient, and the ability to purchase and invest in this technology. We’re fortunate to have this level of support.”

From your perspective, why is it often beneficial to have CTs, MRIs, and other scans done in-house?

“We want to provide not only the best read, but an accurate read, and our patients often have complex histories. If patients are having their imaging done here, we have easy and efficient access to medical records. When patients have their scans done at a different hospital, there may not be access to all of their history, and that can impact how the exam is interpreted. It especially applies with patients who have had prior surgeries. Sometimes we can’t always tell if they’ve had surgery from looking at the imaging.

“Having scans done here also provides consistency for follow-up. We then know how they were performed because we have set protocols that we use. Anyone can go and get a routine scan, but if there’s something specific like a type of cancer that we need to scan, protocols are really important for the correct diagnosis.

“Advanced imaging, advanced protocols, having a consolidated report for the patient, and then having those reports to compare to, are really important to the overall patient experience.”

Can you give us an example of when it was helpful to know the patient’s history?

“Just recently, a patient had an emergency C-section at an outside hospital because of bleeding, and they were still having problems with postoperative bleeding, so they were transferred here on the weekend. The patient had a CT scan that evening and there definitely was bleeding occurring in the pelvis, but there was also what appeared to be a foreign body. We were scratching our heads trying to figure out what we were seeing.

“The resident on-call had done an excellent job making a report, communicating with the clinician, and when I was here in the morning, I also agreed there was a foreign body. Because the operation was outside of the hospital, we made phone calls and talked to the surgeon, who agreed there was material—a gel foam—left in the pelvis to help control bleeding. It was important to know that history to make sure the patient had the correct diagnosis and the appropriate care.”

What else makes the patient experience unique when it comes to diagnostic scans here?

“The commitment to education and research is well supported by the department. Having exams done here means there’s access to experts reading the exams.

“We’re all fellowship trained, and we all are focused on the specific area that we’re practicing in. I’m focused on abdominal imaging. I’m not trying to read a brain MRI, or an ankle MRI, which I wouldn’t be up-to-date on the latest kind of imaging protocol or the pathologies. Whereas, in my specialty field, I’m focused on that, and I’m practicing that daily.

“Our residents are on the frontline taking care of these patients in terms of reading their exams, protocoling the exam, and communicating the results to the clinicians, and we’re invested in their education, giving them resources to succeed.

“Also, the Radiation Sciences Program is a very well-respected program, whether it’s diagnostic imaging, or advanced imaging like CT, MRI, or ultrasound, our technologists are well trained. They often alert us of significant findings so we can prioritize a patient’s exam. For example, if they run a CT scan and find something unexpected, they’ll call and communicate that to us. Or, the patient might be coming from two hours away, and we’ll look at a scan sooner so that the patient doesn’t have to leave and come back.”

Are there situations where it’s beneficial to have a scan asap?

“Yes—prime examples are in the ER. Patients are coming in acutely ill, and they need an exam, so our workflow is such that we can accommodate those patients. And then there are patients who are traveling from farther away, and we want to coordinate their exam to be done on the same day. Our department has really tried to ensure patients can have their scans done before their clinic appointments so that the physician can discuss the imaging results and formulate a plan. That continues to be a work in progress with scheduling, but we’re really working to provide those services. And then, we’re now offering additional availability for patients to have scans done in the evening or on Saturdays. The convenience of not having to miss time from work is really beneficial.”

What makes you proud to come to work?

“It’s a multifaceted answer. It’s knowing that I’m making a difference in the patients that I’m taking care of and working with the people that I think of as my second family. We’re all there to help each other out, and these people are not only my colleagues but also friends.”