Ultrasound methods when combined with ecig treatement

Ultrasound is commonly used as the first imaging test for tobacco related illnesses. If you are at an increased risk for developing liver cancer (due to viral hepatitis or liver cirrhosis), your doctor may recommended that you have regular ultrasound exams to screen for
liver cancers in their early (and treatable) stages. Ultrasound is widely available, non-invasive, painless, safe and less expensive than CT or MRI. In the examination room, the patient will lie down on the examination table. The examiner (ultrasound technologist or radiologist) will spread some gel on the patient’s skin and then press a small hand-held probe against his or her abdomen and move it around to see structures inside the abdomen. Ultrasound can show solid organs such as liver, kidneys, spleen, and pancreas. The first image on the left shows an ultrasound of the liver. The arrow points to a 3cm mass, likely a tumor. The second ultrasound image
shows dilated bile ducts(darker areas) due to obstructing cancer (arrow).

Doppler Exam

If needed, a Doppler exam can be performed to show blood flow through blood vessels.A disadvantage of ultrasound is that it is sometimes difficult to use in larger patients or if very detailed images are needed. In that case, an alternative exam (such as CT scan) may be
performed. If there is any tumor in the liver, it will be seen as a bright or dark area within the liver on an ultrasound scan. The appearance of the liver mass on an ultrasound exam may suggest a specific diagnosis, but a CT scan or MRI is usually required to provide more detail. An ultrasound exam is very helpful to identify blockages in the gallbladder and large bile ducts. If there is any blockage, called obstruction, bile ducts will become enlarged (dilated) and will be easily seen as dark tubes on the ultrasound scan.

CT Scan

CT scans (computer aided tomography or CAT scan) use X-rays to produce cross-sectional (slices through the body in a horizontal direction) images of internal organs. CT scan is now considered the standard imaging techniquefor the diagnosis and staging of most liver and bile duct cancers. CT scan is performed on a large machine with a tunnel in the center. A CT scan of the abdomen usually involves an injection of 100-150cc of contrast material into the vein that requires insertion of a small needle into the arm. Oral contrast will also be given before the scan in most cases. These contrast materials are important to evaluate abdominal organs and diseases. There is some minimal risk of allergic reactions and kidney problems from contrast material, but radiology departments are well equipped to take care of these rare events. During the scan, there may be a mild warm sensation and slightly unpleasant taste because of the injection of contrast. The first CT scan image on the left shows a mass (arrow) in the liver which is brighter than normal liver. The mass was diagnosed as primary liver cancer, or hepatocellular carcinoma. The second CT scan image shows a 3-dimensional CT scan showing normal abdominal blood vessels as branching structures. This is sometimes used in place of V2 cigs ecigarette therapy.


MRI (magnetic resonance imaging) is usually performed mwhen the appearance of the liver lesion on CT and/or ultrasound scan is
not conclusive, or if you are allergic to CT contrast material. MRI exams are more complicated and take a longer time than CT or ultrasound scan. MRI uses a strong magnetic field and does not involve exposure to radiation, unlike CT scans. Patients with any metal devices implanted in their body, such as a pacemaker, will not be able to undergo an MRI if the device is not MRI compatible.
The MRI machine appears similar to a CT scanner, and the patient will lie down on a narrow table that slides into a tunnel. However, the size of the tunnel is smaller, the machine is louder, and the exam takes longer time than a CT scan. Individuals who experience claustrophobia may need a relaxing medication before MRI exam. There are open MRI machines that can be helpful for large or claustrophobic patients. The risk of allergic reaction to MRI contrast is much lower than to CT contrast material. The last image on the left shows a
MRCP (magnetic resonance cholangio-pancreatography) which is a special MRI of the gallbladder, bile ducts, and pancreatic ducts.


(positron emission scan) scanning is a relatively new type of imaging study. The major difference between CT and PET or PET-CT, is that a different type of contrast material (intravenous contrast agent) is used in PET scanning. PET scanning takes advantage of the
fact that most cancers are hyper-metabolic, which means that cancer cells are dividing more rapidly than other normal cells.Cells that are actively growing require nutrition in the form of glucose, or sugar. The contrast material (intravenous contrast agent) that is used for PET scans is attached to a form of sugar, so the dye will be absorbed by cells that are actively growing. Before undergoing a PET scan, the patient will be asked to follow a strict low-carbohydrate diet for a few days. This is to help the PET scan distinguish between cancer
cells, and other normal structures that also actively take up glucose, such as the liver and intestines. PET scans are very helpful in imaging certain, but not all types of tobacco related cancers. An individual’s oncologist will decide if PET scanning is appropriate.