Health examination items and equipment

• What is the scope, targets and test frequency of cerebrovascular MRI?

  • Head and neck examinations (including cerebrum, cerebellum, brain stem, eyes, nostrils, nasopharynx, paranasal sinuses, middle and inner ear, etc.), intra- and extra-cranial cerebrovascular MRI and carotid ultrasound.  
  • For middle-aged subjects with multiple risk factors such as hypertension, diabetes, smoking or being overweight, cerebrovascular MRI is recommended. As to the follow-up visits --- it may depend on the assessments and recommendations of the physician. 

• What should be noticed after endoscopic biopsies or polypectomy?

  • In general, the operation wound will be stabilized one week after the procedure. However, the wound could be larger due to larger polyps. Therefore, all subjects receiving a polypectomy should closely pay attention to symptoms such as abdominal pain or bleeding two weeks after the procedure. Please inform our medical staff about any discomfort (including abdominal pain, fever, black stool or bloody stool) two weeks after the procedure. Note: If there’s only a few blood streaks or hard black stool, do not panic and keep observation. Lots of blood clots or asphalt-like stool will be considered as abnormalities.  
  • Do NOT consume spicy food or stimulants (including coffee, tea, alcohol, chili, wine-cooked chicken soup and ginger duck stew), hot soup, or any food that can cause diarrhea or uncooked vegetables, meat and sea food (e.g. raw sea food or salad) one week after the procedure. 
  • Do NOT carry heavy objects, use a spa, mountain climbing and perform vigorous exercise (e.g. swimming) one week after the procedure, particularly the actions/movements involving abdominal muscles. 
  • For subjects who received a polypectomy, do NOT take airplanes one week after the procedure. (Subjects received only biopsies do not apply to such limitation). 
  • Pay attention to post-operative defecation. A day rest is strongly recommended after the procedure. 
  • Light diet is recommended for 3-5 days after the procedure. Do NOT consume gas producing food such as dairy products or beans and high-fiber diet. You can resume a regular diet after recovery. 
  • For those who are taking ginkgo or anti-coagulants, they should discontinue the anti-coagulant after the biopsy or polypectomy following the instructions of the surgeon. 

• What is the scope, approach, targets and test frequency of breast MRI?

  • A Breast MRI is a test that uses fine image slices (0.2 cm) to integrate a 3D image. In combination with a breast ultrasound, it is the best, pain-free and fast approach to screen breast cancer.  
  • Women with high-risk factors (e.g. family history of breast cancer) and aged above 40 years should receive at least once breast MRI annually. 

• Who are the high-risk population of breast cancer and thus require earl screening?

  • Females aged above 40 years.  
  • Menarche occurred before the age of 12 and menopause occurred after the age of 55. 
  • Never given birth or gave the 1st delivery after the age of 30. 
  • Received breast augmentation (especially silicone injection and the insertion of silicone bags filled with saline).
  • Received large doses of radiation over the breast.  
  • With family history of breast cancer.  
  • Had other types of cancer.  
  • Received local tumor discectomy. 
  • Taking oral contraceptives and receiving hormone support supplements after menopause for a long time. 
  • Female consuming high-fat and high-calorie food.

• What are the differences between breast MRI and regular breast ultrasound or mammography?

  Breast ultrasound has excellent local tissue differentiation capacities. However, the accuracy of diagnosis replies on the experience and performance of the clinician at the initial stage. As with mammography, it requires forceful bilateral compression of the breast, which not only may cause pain, but is less sensitive to detect lesions in females with dense ductal tissues. Breast MRI is very sensitive, even applicable to breast lesion sizes under 1 cm; plus the application of contrast exclusive for breast cancer detection (abnormal vessels may emit fluorescence in the image), the accuracy of detecting benign and malignant breast cancers using breast MRI has been greatly enhanced, of which is the most effective approach to screen breast cancer at present. 

• Systemic MRI in males includes dynamic liver MRI, why is this item is not optional for females?

  Systemic MRI already consists of liver imaging, a multiple sectional (0.3~0.4 cm thickness) and detailed screening without the assistance of contrast. As the prevalence of liver cancer and the mortality rate of liver cancer in males are significantly higher, it is required to annex an additional liver MRI examination with the assistance of contrast. 

• Is endoscopy required with the availability of MRI examination?

  The gastrointestinal tract is a mucosal organ with an empty lumen. Micro-lesions on the mucus may be hidden under the folder of mucus at the beginning of pathological changes. In this case, based on the concept of early detection and early intervention, gastroscopy and colonoscopy are the preliminary screening tools to detect early mucosal lesions.

• If I received systemic MRI, do I still need to give blood for blood tests and receive endoscopy?

  Blood tests and endoscopy are both routine health examination items. It is suggested to receive blood tests once every three years between the age of 40-65 and once annually at age of 65 or above. Regarding endoscopy, it is recommended to receive at least one gastroscopy every 2-3 years and one colonoscopy every 3-5 years at age of 40 or above. (For those with gastric ulcers, gastritis, history of polyps in stomach or large intestines, or family history of gastric cancer or colon cancer, it is recommended to receive one gastroenteroloscopy annually).

• The MRI is a thorough test tool, what is the purpose of adding an ultrasound examination?

  Ultrasound has excellent resolution over superficial human soft tissues, thyroid glands and carotid arteries, while MRI has excellent differentiation capacities on different tissue compositions. The combination of these two pieces of equipment can enhance the accuracy of the diagnostic rate. 

• Does MRI examination require the injection of contrast?

  Systemic MRI for tumor screening does not require the injection of contrast. On the contrary, intravenous injection of Gadolinium is required for cerebrovascular and liver/breast MRI to facilitate the expression of tumors. 

• Does it require injecting contrast for MRI examination? What is the purpose of contrast injection? Is it dangerous? May I receive such injection if I have allergies?

  • The injection of contrast for MRI examination can enhance the accuracy of the diagnostic rate. Take the MRI examinations in our center as examples, we may inject contrast for liver MRI examinations in males and breast or cerebrovascular MRI examinations in females to enhance the resolutions of images. The intravenous injection of a small amount of contrast allows reflecting signal changes and images in vessels or tissues under MRI examination to facilitate the expression of pathological lesions. 
  • Normally the contrast for X-ray or CT scan is iodine, which may cause allergic reactions easily. However, although it is not guaranteed to cause zero adverse reactions, the most updated non-ionic contrast used for MRI examination is considered the safest contrast in clinical practice so far. More than half of the dose can be metabolized through the kidneys within 80 mins. According to the results of approximately 10 million-subject clinical trial, the safety of contrast injection for MRI examination has been confirmed. Most of the subjects did not show any special sensation or discomfort. However, still extremely few subjects (~1/10,000) may develop mild drug reactions such as vomiting, sneezing or urticaria. The customers should not worry about any of the allergic reactions since our center is equipped with comprehensive medical facilities and our staff are well-trained with safety measures. 

• What is MRI?

  Magnetic resonance imaging (MRI) is a new, revolutionary medical imaging tool in recent years that uses magnetic field and the pulses of radio waves to clearly reflect human anatomical images. The compositions such as skin, fat, muscles, skeletons and water can be clearly differentiated using MRI examination without being affected by overlapped organs or bone impedance. Therefore, the resolution of MRI is greatly superior to that of X-ray, ultrasound or even CT. 

• Does the MRI examination cause any risks, damage or side effects to the subject?

  MRI is a non-invasive, zero-radiation, multi-directional scanning test that offers 3D images with high-contrast resolutions. Therefore, MRI is considered an indispensable diagnostic tool in modern medical practice. One of the advantages is that MRI examination, unlike conventional X-ray, does not cause any radiation damage to the patients. 

• Is the electromagnetic wave generated by the health examination tool, MRI, harmful to human bodies?

  MRI is a radiation-free, non-invasive medical test that uses only one-billionth energy of conventional X-ray, one-fifteenth energy of cell phones, and half the energy of radio.

• There are several health examination packages available on the market, including routine health examination programs, MRI, CT, PET scans, etc. What are the differences between the health examination packages of the “Executive Health Management Center, Cheng Ching Hospital” and those of other centers?

  Our center is equipped with advanced facilities including 3T-MRI, iCT, Painless NBI Gastroenteroloscopy and high-resolution ultrasonography, and offers customized health examination programs upon the individual’s or company’s request. In other words, we choose proper methods and tools for health examinations in different populations. MRI is the most advanced, non-invasive, radiation-free medical diagnostic tool, and the best screening tool for systemic tumors (the cancer screening rate is 3.7%). Therefore, it has excellent clinical value. Our center also uses low-dose chest CT for cardiopulmonary screening to evaluate the risks of cardiovascular diseases, as well as early detection of pulmonary-related symptoms and signs. Painless NBI Gastroenteroloscopy is the best tool for GI tract examinations, which can effectively screen for GI tract disorders, particularly colon cancer. Because PET scans have a high dose of radiation, it is not recommended to be used as a health examination tool. In addition, all the screening or diagnostic tools in our center are for health examinations only, our customers do not need to share the tools with clinic patients, which may save time and reduce the risks of cross-infections. 

• What are the differences between the computed tomography (CT) and the magnetic resonance imaging (MRI)?

  The iCT in our center is the best screening tool for coronary artery and pulmonary diseases with extremely low radiation, while the MRI is a non-invasive, radiation-free and excellent diagnostic tool in health examination program for systemic tumors and micro-vasculopathy or micro-neuropathy.  

• What are the differences between PET scan and MRI examinations? Which one should I choose?

  The injection of isotopes is required for PET scan, of which has strong radiation and poor resolution. The cancer screening rate of PET scan is approximately 1.1%. On the contrary, MRI is a non-invasive and radiation-free diagnostic tool with excellent resolution, and the cancer screening rate is up to 3.7%. 

• What is the scope, approach, targets and test frequency of MRI for tumor screening?

  The total examination time of MRI is less than one hour. MRI examination uses sectional scanning (per 0.5~1 cm thickness) to integrate approximately 2,000~3,000 images. The scanning fields cover 8 major parts in human bodies including the head, neck, chest, upper abdomen, pelvis, cervical spine, thoracic spine and lumbar spine. At least once annually systemic tumor MRI screening is recommended for subjects aged 40 years or above. 

• What is the scope, approach, targets and test frequency of liver MRI?

  Dynamic MRI with fine slicing images (per 0.3~0.4 cm) plus high-resolution ultrasound are the most comprehensive liver examinations for early liver cancer screening. For hepatitis virus B and C carriers, it is recommended to receive at least once annual liver MRI or ultrasound examination. For patients with chronic hepatitis, it is recommended to receive a liver MRI or ultrasound examination once every three months. 

• What is the purpose and target population of health examinations? Is there any limitation on the age of the subject? Does it require once annually, or what is the proper test frequency?

  The main purpose of health examination is to evaluate the risks of different diseases. According to the guidelines of the American Cancer Society, it is recommended to receive a once-annual systemic health examination in populations aged 40 years or above. The test items should cover systemic tumor screening and hematological biochemistry tests. Due to external environmental and diet-related risk factors, it is recommended to receive systemic health examination as early as possible. During the first systemic health examination, the testing items are suggested to be as thorough as possible. Afterward, the required items can be screened for once every 6 months as follow-ups. MRI or CT scans help rapidly and clearly detect systemic tumors and the symptoms and signs of disorders. Therefore, it is recommended to receive MRI or CT scan once annually. Moreover, gastroenteroloscopy is required once every 2~3 years, but patients with gastric ulcers, gastritis, a history of polyps in the stomach and colon or family history of gastric cancer or colon cancer should receive routine gastroenteroloscopy once annually.

• After MRI examination, do I still need other routine physical examinations?

  MRI examination primarily covers body parts such as systemic tumors, the cerebrovascular system and liver/breast. The stomach and large intestines are mucosal organs with an empty lumen, of which gastroscopy and colonoscopy are recommended for early detection. The cancer screening rate of MRI is 3.7%, which can be elevated by 2.5% combining gastroscopy or colonoscopy and reach 5-8 times higher than routine health examination programs. For cardiopulmonary screening, CT scans are recommended while the results of routine blood tests, fecal occult test and urinalysis are adjunct references. 

• I am not feeling well, but the etiology is still unknown after visiting several clinics. I’ve heard that MRI is a good diagnostic tool and thus asked my doctor to arrange an MRI examination for me. However, my request was rejected by my doctor due to his/her judgment of redundancy. Do I really need the MRI examination?

  If you have already developed symptoms, it is recommended to seek special medical assistance. However, if you would like to rule out the possibilities of cancer, MRI examination could be your preferable choice. 

• Can all the cancers in vivo be detected using systemic MRI examination?

  MRI is so far the most advanced, non-invasive and radiation-free medical diagnostic equipment and the best screening tool with great clinical values. The prevalence of cancer in regular population is approximately 2.5%-3% while cancer screening rates of routine overnight health examination programs are nearly 0.3%-0.5%. However, cancer screening rate of MRI examination is about 3.7%, which can be elevated by 2.5% in combination with gastroscopy or colonoscopy and reach 5-8 times higher than former tests (while cancer screening rate of PET scan is approximately 1.1% but with potential radiation damages). With the development of medical technology, no single test can be considered as risk-free yet. However, our center aims to provide the best tools at present and professional medical services to improve your health.

• What problems can be detected by abdominal ultrasound examination?

  Ultrasonic detection is a good tool for preliminary screening of diseases due to its simple process and harmless to humans, especially for liver and gallbladder related problems. Abdominal ultrasound examination has become very popular in Taiwan, and it can be done from clinics, hospitals to health examination centers.

  Before the ultrasound examination, you need to fast for 6-8 hours. Diabetes patients are advised not to take hypoglycemic drugs before the examination to avoid the danger of fasting and hypoglycemia.

  People with high body fat are not recommended to do abdominal ultrasound examination, because too much fat around the abdomen will hinder the ultrasound transmission and make it impossible to see the organs clearly.