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Coronary Computed Tomography Angiography

Comprehensive Genetic Screening

CT Lung Screening Program

CT Colonography Screening Program

Coronary Computed Tomography Angiography

A coronary computed tomography angiography (CCTA) is a non-invasive method of imaging the coronary vessels, the arteries that supply blood to the heart. Compared to conventional angiography, coronary CT angiography requires very little preparation, no recovery time and yields highly specific results. A CT calcium score, to measure mature atherosclerotic plaque, is performed at the same time.

With CCTA we can identify calcified (hard) plaque and noncalcified (soft) plaque. Soft plaque deposits are at greater risk of breaking away and blocking the downstream artery, causing an acute cardiac event (heart attack). The soft plaque is undetectable on CT calcium score alone.

What is Mammography?

Mammography is an essential tool for the early detection of breast cancer. Regular mammograms can help save lives by identifying breast cancer at its earliest and most treatable stage, often long before it can be felt.

Mammography is a special type of medical imaging that is used to detect and diagnose breast diseases, including breast cancer. It involves taking low-dose X-ray images of the breasts to look for any abnormalities or changes in the breast tissue even before a patient or doctor can feel a lump.

Digital Breast Tomosynthesis (DBT), also known as 3D mammography, is an advanced imaging technique that provides a three-dimensional view of the breast. It is used in combination with traditional 2D mammography to aid in the detection and diagnosis of breast cancer.

In DBT, a series of low-dose X-ray images are taken of the breast from different angles. These images are then reconstructed into a three-dimensional image of the breast, allowing radiologists to examine the breast tissue layer by layer. This provides a more detailed and accurate view of the breast, making it easier to detect small abnormalities or lesions that may be hidden or obscured in traditional 2D mammograms.

The addition of DBT to mammography has been shown to improve the accuracy of breast cancer detection, especially in women with dense breast tissue. Dense breast tissue can make it more challenging to detect cancers with conventional mammography alone, as the dense tissue can mask or hide abnormalities. DBT helps to overcome this limitation by providing clearer and more detailed images of the breast.

Why is Mammography Useful in Breast Health?

Mammography is important because it can help detect breast cancer at an early stage, when the treatment is most effective, and the prognosis is best. Regular mammograms can help identify small tumors or changes in breast tissue that may not be felt during a physical exam. By detecting breast cancer earlier, women have more treatment options available to them, often including options that are less aggressive, and a higher chance of successful treatment outcomes.

FAQs

How do I Prepare for the Exam?

Once Beam Radiology receives the CCTA requisition from your health care provider, we will contact you to schedule your appointment and ask a few relevant medical questions about you. We will also provide you instructions to prepare for your exam and, if required, arrange blood work, and an ECG. After we review this information, If required,  we will arrange for a heart medication (metoprolol, a beta blocker) and instructions to be delivered to you to take before the exam.

This medication can make you feel dizzy or tired, so although you are not required to have a driver for this procedure, please consider that an option, or make alternative arrangements such as Uber.

Preparation Instructions:

  • 48 HOURS BEFORE, please refrain from taking erectile dysfunction medications (Viagra or Cialis)
  • 24 HOURS BEFORE your appointment, please avoid all NSAIDS (Advil, Motrin, etc.) and all CAFFEINE PRODUCTS (e.g., coffee, tea, chocolate, Excedrin, decaf coffee, decaf tea)
  • ON THE DAY OF YOUR TEST, avoid strenuous exercise, do not consume any food or drink (except water) 2 HOURS before your exam. If you have diabetes, you may have dry toast and juice.
  • Please arrive 15 minutes prior to your nursing intake appointment.
  • If prescribed, please remember to take one tablet of your Beta Blocker 2 hours prior to your appointment arrival time (ex. You are asked to arrive at 10:00 am, please take this medication at 8:00 am). You may be given an additional Beta Blocker, based on your heart rate at the time of the exam. This medication can make you feel dizzy or tired, so although you are not required to have a driver for this procedure, please consider that an option, or make alternative arrangements such as Uber.
  • Please bring photo identification and your provincial health card.
  • Wear comfortable clothes to keep warm. We will need to attach ECG leads on your chest and establish IV access in your elbow so you may be changed into a a long gown
  • Please do not bring children who require supervision.
What Happens During My Exam?
  • You may be asked to change into a gown or scrubs.
  • You will be taken into our nursing area when a team member will will establish IV access (for the CT dye), take your blood pressure and determine your resting heart rate. If your heart rate is too high, you may be given a beta blocker medication to calm the heart rate.  Once your heart rate is in the acceptable range and we are ready to start the exam, you will be given a single spray of the nitroglycerin under your tongue.
  • In the CT suite, the technologist will help you get into a comfortable position and will attach the leads for the heart rate monitor. This will give the machine the information needed to capture the images at the exact right timing between beats of your heart. There is only a fraction of a second between heartbeats.
  • The technologist will cover you with a blanket, and leave the room to begin the scan, but they will be able to communicate with you throughout the exam by microphone and speaker.
  • This exam has four parts:
    1. The technologist will take some initial images to test and ensure you are in the best position for the scan. There is an automatic injector that delivers contrast solution to your IV to coincide precisely with the scans.
    2. You are advanced into the scanner and the machine spins around your body acquiring the images so that your calcium score can be calculated using specific CT software.
    3. You will then be moved into the scanner where the machine will take another series of images as the contrast solution is injected through your IV. This will determine the time it takes for the solution to reach your heart vessels. When injecting contrast, it is common to experience a metallic taste or a warming sensation throughout your body. You may also feel the sensation of needing to urinate, this is also normal.
    4. Finally, we will perform the coronary angiogram. You will be advanced into the machine for a final time and a larger amount of contrast solution will be added to your IV while the scan begins. At different points during these steps, the technologist will instruct you to hold your breath for approximately 10-15 seconds. This is done to ensure the best image.
What to Expect Post Exam?

After your scan, you will return to the nursing area. You will be given a drink and small snack, we will check your blood pressure, heart rate and monitor for any reaction. You may feel tired and some patients develop a mild headache. Once your vitals have returned to normal, we will remove your IV and review the below points for post care.

Post Care Instructions:

  1. If you are taking the medication Metformin, this should be held for 48 hours
  2. Monitor blood glucose closely if on diabetic medications for the next 48 hours
  3. Avoid strenuous activity for 24 hours
  4. Drink fluids to help flush contrast dye from your system
  5. Resume usual medications unless you have been told to delay or adjust (such as metformin)

Serious side effects are exceedingly rare, but please proceed to the nearest emergency room if you experience:

  • Shortness of breath
  • Chest pain
  • Severe dizziness or fainting
  • Signs of an allergic reaction (hives, swelling, difficulty breathing)
  • Blood sugar symptoms become hard to manage
What Are The Risks?
During your CT scan you will be exposed to low levels of radiation. Although the level of radiation from CT scans is higher than those of an x-ray, CT scans have not been shown to cause long-term effects.
If you are pregnant or if you think you may be pregnant, it is important to discuss your CT exam with your doctor prior to your appointment. Although the radiation from a CT exam is not likely to cause any harm to your baby, your doctor may prescribe another diagnostic imaging procedure such as an MRI or Ultrasound.
If CT contrast is to be used during your procedure, it is important to discuss with your doctor prior to the exam. Patients that are allergic to contrast material may experience minor rash or itchiness, however, more extreme reactions are possible. If you are a patient with Renal Disease or Diabetes, it is also important to discuss the use of CT contrast in your exam.
What is CT Contrast?

CT contrast is a special dye used in some CT exams to help highlight the areas of your body that are to be examined. The dye is designed to appear white on CT images, which helps emphasize internal structures of the body in CT images. It is important to discuss the use of CT contrast with your doctor prior to your procedure.

Comprehensive Genetic Screening

CT Lung Screening Program

CT Colonography Screening Program

Coronary Computed Tomography Angiography

Your Health is Important to Us

If you have any questions or would like to learn more, please
contact us. We look forward to supporting your journey to better health.

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Dr. Olivier Clerk-Lamalice​

Dr. Olivier Clerk-Lamalice

MD-MSc, FRCPC, FIPP

Dr. Clerk is a radiologist and fellowship-trained interventional radiologist with a wide array of experience in both interventional pain management and diagnostic imaging. In addition to providing expert patient care, Dr. Clerk places utmost importance on building a compassionate practice that recognizes patients as people, not numbers.

When you choose Beam, you can be confident that Dr. Clerk will stay with you throughout your care journey and help you make smart decisions about your pain and imaging needs.

Education & Training

Université de Sherbrooke
Medical School

Université de Sherbrooke
Residency | Diagnostic Radiology

Harvard Medical School
Fellowship | Neuroradiology

The Spine Fracture Institute
Fellowship | Interventional Pain Management