In addition to being the first site to offer Digital Mammography in Dover, MDI has again raised the bar in the detection of breast cancer. We first began by updating the technical aspect of mammography by introducing the digital technique. We have now updated the other half of the equation which is the doctor, the Radiologist, who looks at the digital films and determines if he/she sees cancer or the signs of cancer. TWO Radiologists will now look at your digital mammogram to further increase the chances that a cancer is detected; this is known as Double Read Mammography.

A simple analogy: If you lost a diamond ring at the beach, what would you do to find it? First you would try and get the best technology available, in this case a strong metal detector. Next, you yourself would look thoroughly throughout the sand for the ring. What would increase your chances of finding this tiny ring amidst a vast landscape of sand? The obvious answer is another person! This is the concept behind Double Read Mammography. Improve the odds of detecting breast cancer by having a second radiologist look at the films in addition to the first radiologist.

Many mammography facilities have been practicing double read mammography for years in New York City (where I did my schooling/training) as well as other cities. In fact, according to a New England Journal of Medicine article, double reading is the standard of care in 12 European countries. In addition, it has been found that double reading of a mammogram leads to increased detection of cancer by 4-14%! The article states that the resources are not available in the US and that is why double reading is not widely practiced. Well, these resources exist in NYC and other large cities and again we at MDI believe that the women of our community should be afforded the same options in healthcare offered to women in our major cities.

I would first like to mention that we are making no extra money by doing this. We cannot and do not bill the insurance companies for extra money. We do not charge the patient for this extra service. There is no increased copay or cost to anyone. We strongly believe in this service and are offering it to all of our patients, free of charge, as we firmly believe it is the right thing to do.

Mammography is about numbers and experience. The only way to become better at detecting cancer is to have years of experience under your belt and to have seen tens of thousands of mammograms. My father, Dr. Mahendra Parikh, the founder of MDI, has been a practicing radiologist for over 30 years. He has seen more mammograms than most radiologists in Delaware while practicing in Dover for the past 30 years. Our double read service begins with his extensive experience. He first analyzes the films and compares them with your old films (if available). A computer program is also utilized as a “second look” tool. After looking at the images and the computer’s analysis, he comes to a conclusion for you and your doctor. Over the next days, I then look at those same films and form my own impression. If there is a difference in opinion, my father and I discuss the mammogram and come to a joint conclusion. If this differs from the original opinion, you and your doctor will be notified regarding the follow up recommended as discussed by both of us.

In addition to advancing the technology with the latest equipment and protocols/services in radiology, we have also decided to add a personal approach to radiology. For the longest time, the radiologist has been known as the doctor who sits in the dark room and looks at x-rays. At MDI, we are interested in you as well as your pictures. We will be more than glad to go over your images with you while you wait so that you may finally gain an understanding as to what your mammogram means, all you have to do is ask to see your Radiologist! You have a choice, tell your doctor that you would like your next mammogram/radiology test (MRI, CAT scan, etc) to be done at MDI and we will be glad to discuss it with you.

For more information on digital mammography,
or to schedule contact Mid-Delaware Imaging
at (302)734-9888.

Anush Parikh, M.D. is with Mid-Delaware Imaging in Dover, DE. Dr. Parikh was raised in Dover and educated through the Holy Cross, Caesar Rodney and St. Andrew’s school systems. He attended New York University for undergraduate training where he majored in Anthropology. Dr. Parikh received his M.D. at Syracuse-Upstate Medical University where he achieved the medical academic honor of Alpha Omega Alpha. He moved back to NYC where he completed his Internship at St. Vincent’s Catholic Medical Center. This was followed by a residency in Diagnostic Radiology at Beth Israel Medical Center and a mini-fellowship in cardiac/coronary CT. Dr. Parikh has recently returned to his community where he is practicing along with his father Mahendra Parikh, M.D. (who has been a practicing radiologist and serving the community of Dover for 30 years).

Testimonials:
“Many women would feel more comfortable if their radiologists were using both CAD and double reads. If given just one of those options, I would prefer the double reads. You don’t want them (the radiologists) to find something, but if something is there, you want to make sure they do get it and they get it in time. There is a fear that they might miss it, but if you have two different people looking at it, you’re less likely to miss it.” ~ Okemah Strickland, board of trustees for the Delaware Breast Cancer Coalition

“Finally, we are receiving 2009 care in central Delaware. I had been driving to NY for my mammograms and had been paying for double reads. It’s great to know that this is now available for free in Dover and that one of the Dr Parikhs will go over the films with me and let me know what’s going on before I leave. I hated waiting for a letter in the mail.” ~ Amy L.

In addition to being the first site to offer Digital Mammography in Dover, MDI has again raised the bar in the detection of breast cancer. We first began by updating the technical aspect of mammography by introducing the digital technique. We have now updated the other half of the equation which is the doctor, the Radiologist, who looks at the digital films and determines if he/she sees cancer or the signs of cancer. TWO Radiologists will now look at your digital mammogram to further increase the chances that a cancer is detected; this is known as Double Read Mammography.

A simple analogy: If you lost a diamond ring at the beach, what would you do to find it? First you would try and get the best technology available, in this case a strong metal detector. Next, you yourself would look thoroughly throughout the sand for the ring. What would increase your chances of finding this tiny ring amidst a vast landscape of sand? The obvious answer is another person! This is the concept behind Double Read Mammography. Improve the odds of detecting breast cancer by having a second radiologist look at the films in addition to the first radiologist.

Many mammography facilities have been practicing double read mammography for years in New York City (where I did my schooling/training) as well as other cities. In fact, according to a New England Journal of Medicine article, double reading is the standard of care in 12 European countries. In addition, it has been found that double reading of a mammogram leads to increased detection of cancer by 4-14%! The article states that the resources are not available in the US and that is why double reading is not widely practiced. Well, these resources exist in NYC and other large cities and again we at MDI believe that the women of our community should be afforded the same options in healthcare offered to women in our major cities.
I would first like to mention that we are making no extra money by doing this. We cannot and do not bill the insurance companies for extra money. We do not charge the patient for this extra service. There is no increased copay or cost to anyone. We strongly believe in this service and are offering it to all of our patients, free of charge as we firmly believe it is the right thing to do.

Mammography is about numbers and experience. The only way to become better at detecting cancer is to have years of experience under your belt and to have seen tens of thousands of mammograms. My father, Dr. Mahendra Parikh, the founder of MDI, has been a practicing radiologist for over 30 years. He has seen more mammograms than most radiologists in Delaware while practicing in Dover for the past 30 years. Our double read service begins with his extensive experience. He first analyzes the films and compares them with your old films (if available). A computer program is also utilized as a “second look” tool. After looking at the images and the computer’s analysis, he comes to a conclusion for you and your doctor. Over the next days, I then look at those same films and form my own impression. If there is a difference in opinion, my father and I discuss the mammogram and come to a joint conclusion. If this differs from the original opinion, you and your doctor will be notified regarding the follow up recommended as discussed by both of us.

In addition to advancing the technology with the latest equipment and protocols/services in radiology, we have also decided to add a personal approach to radiology. For the longest time, the radiologist has been known as the doctor who sits in the dark room and looks at x-rays. At MDI, we are interested in you as well as your pictures. We will be more than glad to go over your images with you while you wait so that you may finally gain an understanding as to what your mammogram means, all you have to do is ask to see your Radiologist! You have a choice, tell your doctor that you would like your next mammogram/radiology test (MRI, CAT scan, etc) to be done at MDI and we will be glad to discuss it with you.

For more information on digital mammography, or to schedule contact Mid-Delaware Imaging at (302)734-9888.

Anush Parikh, M.D. is with Mid-Delaware Imaging in Dover, DE. Dr. Parikh was raised in Dover and educated through the Holy Cross, Caesar Rodney and St. Andrew’s school systems. He attended New York University for undergraduate training where he majored in Anthropology. Dr. Parikh received his M.D. at Syracuse-Upstate Medical University where he achieved the medical academic honor of Alpha Omega Alpha. He moved back to NYC where he completed his Internship at St. Vincent’s Catholic Medical Center. This was followed by a residency in Diagnostic Radiology at Beth Israel Medical Center and a mini-fellowship in cardiac/coronary CT. Dr. Parikh has recently returned to his community where he is practicing along with his father Mahendra Parikh, M.D. (who has been a practicing radiologist and serving the community of Dover for 30 years).

Testimonials:
“It is unbelievably comforting to know that TWO DOCTORS will be looking at my mammogram. It’s common sense that two doctors or 4 eyes will find more cancers!”    ~Jessica T.

“Finally, we are receiving 2009 care in central Delaware. I had been driving to NY for my mammograms and had been paying for double reads. It’s great to know that this is now available for free in Dover and that one of the Dr Parikhs will go over the films with me and let me know what’s going on before I leave. I hated waiting for a letter in the mail.”    ~Amy L.

By: Anush Parikh, M.D.

Coronary artery disease, heart disease, atherosclerotic disease, cardiovascular disease; the number one killer of Americans goes by many names. Despite the variety with respect to nomenclature, the underlying commonality is blockage of one or more of the arteries of the heart which eventually leads to heart dysfunction/stoppage (heart attack or cardiac arrest).

Coronary artery disease is the buildup of cholesterol/fatty and calcified deposits (plaque) within the arteries of the heart. This overtime leads to narrowing of the blood vessel which can eventually become so severely narrowed that adequate blood flow/oxygen cannot be delivered to the heart muscles. This can produce angina (chest pain with nausea, fatigue, shortness of breath, anxiety, sweating or dizziness among other symptoms). Alternatively, the plaque can rupture and lead to immediate blockage of the arteries and subsequent sudden cardiac arrest. There are many risk factors for coronary heart disease, with the major ones being increasing age, male gender, genetics, smoking, high cholesterol, high blood pressure, low physical activity, obesity, diabetes, stress, and excessive alcohol consumption.

According to the 2009 statistics from the AHA (American Heart Association) one in three female adults has some form of cardiovascular disease (CVD). Since 1984, the number of CVD deaths for women has exceeded the deaths for men. The AHA statistics state that in 2005 in the US, all cardiovascular diseases combined resulted in the death of 454,613 women while all forms of cancer combined resulted in the death of 268,890 women (breast cancer resulted in 41,116 deaths and lung cancer claimed 69,105 lives).

Until now, the primary test to image the arteries of the heart has been an invasive procedure known as cardiac catheterization which typically involves puncturing the femoral artery followed by catheters and wires which are guided from the groin to the heart and evaluated by x-ray. Mid-Delaware Imaging now has the technology to accurately and non-invasively image the arteries of the heart with our new state-of-the art 64 detector/slice CT scanner (CAT scan). This study is known as Coronary CT Angiography.

After obtaining a brief history, the technologist will monitor your heart rate and the radiologist may or may not give you a low dose medication to control your heart rate. The technologist will then place an IV and you will be taken to the CT scanner. Iodine contrast material is then pushed through the IV (same contrast used in the invasive procedure) and the 64 slice CT scanner obtains extremely thin (0.5 mm) images through the heart. These thin images capture details of the moving heart and its arteries which allow us to construct high resolution 3-D images to determine if there is any fatty/cholesterol or calcified deposits (plaque) narrowing the arteries.

A recent study performed at the Cornell Medical Center in New York City found that the non invasive Coronary CT Angiography study has a very high negative predictive value (97-99%) in patients with chest pain who are electively referred for invasive coronary angiography. The higher the negative predictive value, the more effective a test is at excluding disease. Thus, Coronary CT Angiography is a highly effective noninvasive alternative to exclude coronary artery narrowing/stenosis.

This test is only offered at a few facilities in all of Delaware. For this reason, Mid-Delaware Imaging acquired the new 64 slice CT scanner and is proud to announce the availability of this exciting new test to help diagnose coronary artery disease in the patients of our community. This new scanner also obtains high resolution, 3-D images of other parts of the entire body and has revolutionized the way we diagnose old diseases. Cancers are being discovered/diagnosed at smaller sizes. The blocked arteries that cause stroke and vascular disease in the legs are very well evaluated by this incredible new technology.

Speak to your doctor to see if this test may benefit you or call us for more information regarding Coronary CT angiography or for any CAT scan/radiologic procedure. In the meantime, insist that your next CAT scan is performed with the latest 64 detector CT technology. We at Mid-Delaware Imaging, look forward to providing this service to you.

Anush Parikh, M.D. is with Mid-Delaware Imaging in Dover, DE. Dr. Parikh was raised in Dover and educated through the Holy Cross, Caesar Rodney and St. Andrew’s school systems. He attended New York University for undergraduate training where he majored in Anthropology. Dr. Parikh received his M.D. at Syracuse-Upstate Medical University where he achieved the medical academic honor of Alpha Omega Alpha. He moved back to NYC where he completed his Internship at St. Vincent’s Catholic Medical Center. This was followed by a residency in Diagnostic Radiology at Beth Israel Medical Center and a mini-fellowship in cardiac/coronary CT. Dr. Parikh has recently returned to his community where he is practicing along with his father Mahendra Parikh, M.D. (who has been a practicing radiologist and serving the community of Dover for 30 years).

Testimonials:
“My father had a heart attack at a young age. I am 58 years old and had chest pain on and off for a year with inconclusive tests. I had the coronary CT and it showed a severe blockage. I was one of the lucky few who was diagnosed early enough before a heart attack.” ~Lisa M.

“I had vague chest discomfort and have smoked for 20 years. I went to MDI where the incredibly helpful staff walked me through the coronary CT which found a 70% blockage and saved my life.” ~Jen D.

It is known that breast cancer ranks as the second leading cause of death among women (after lung cancer). The key to survival is early detection which allows for early treatment ultimately resulting in the goal of reducing morbidity and mortality. Mammography has always been the most important method of early detection, with digital mammography further improving a time tested method for the detection of breast cancer.

The facts are as follows (American Cancer Society/National Breast Cancer Coalition): The National Cancer Institute estimates a woman in the U.S. has a 1 in 8 chance of developing invasive breast cancer throughout her lifetime. It was estimated that 250,230 new cases of breast cancer were going to be diagnosed in the U.S in 2008. Older women are significantly more likely to get breast cancer than younger women (approximately 80% occur in women older than 50). However, younger women who are diagnosed with breast cancer have a lower survival rate than older women who develop breast cancer. A 2006 statistic cites that Delaware ranked 7th in the U.S. for breast cancer mortality.

Knowing these facts about the prevalence of breast cancer, we return to the most important weapon in our arsenal against breast cancer: early detection with mammography, and now digital mammography. The American Cancer Society recommends that women obtain a yearly screening mammogram beginning at age 40. In addition, all women over 30 should be performing regular self breast exams and undergoing routine clinical breast exams. The goal of mammography is to detect the disease before symptoms manifest. In fact, many breast cancers are only seen with mammography and even when the exact location is known, it may not be felt or detected with a self/clinical breast exam.

The radiology exam known as a screening mammogram routinely includes two x-rays of each breast for a total of four images. The breast is compressed to even out the tissue and x-rays are passed through the breast. With digital mammography the images are reviewed on high-resolution screens and no films are involved. One of the numerous advantages of digital technology includes image post processing (ability to change the contrast and magnify the image) thus optimizing cancer detection. With digital mammography, the images are electronically stored so there is no degradation of quality and the images can be electronically transmitted to other consulting physicians. The technique of digital mammography also results in less radiation to the breasts than the older method of film mammography.

The New England Journal of Medicine published a landmark article on October 27, 2005 entitled, “Diagnostic Performance of Digital versus Film Mammography for Breast-Cancer Screening.” The results of this research article are as follows: Digital mammography is more accurate in women under the age of 50 years, women with radiographically dense breasts, and premenopausal or perimenopausal women.

While training in NYC, I realized that facilities were transitioning to digital mammography to improve the process of breast cancer screening. I was shocked that in 2008 no facility in Dover offered this new technology to the women of my community. I strongly believe that if women in major cities across the U.S. have access to digital mammography then so should the women of Dover. We were pleased to announce in 2008 that Mid-Delaware Imaging was the first facility in Dover to offer digital mammography. The combination of my father’s 30 years of experience and my training with digital radiology place us in a unique position to offer well rounded radiologic care to our patients.

In addition to digital mammography, MDI is a full service radiology practice with the newest generation 64 detector CT scanner, open MRI, ultrasound, x-ray, nuclear medicine, bone density scans, and hip/shoulder steroid injections under x-ray (allowing for precision). When possible and requested we will gladly discuss the results of your test with you and your doctor as we believe in practicing a more personal-patient based approach to radiology. Nearly all insurances are accepted and reimburse digital mammography with no extra or added cost to the patient.

For more information on digital mammography, or to schedule contact Mid-Delaware Imaging at (302)734-9888.

Anush Parikh, M.D. is with Mid-Delaware Imaging in Dover, DE. Dr. Parikh was raised in Dover and educated through the Holy Cross, Caesar Rodney and St. Andrew’s school systems. He attended New York University for undergraduate training where he majored in Anthropology. Dr. Parikh received his M.D. at Syracuse-Upstate Medical University where he achieved the medical academic honor of Alpha Omega Alpha. He moved back to NYC where he completed his Internship at St. Vincent’s Catholic Medical Center. This was followed by a residency in Diagnostic Radiology at Beth Israel Medical Center and a mini-fellowship in cardiac/coronary CT. Dr. Parikh has recently returned to his community where he is practicing along with his father Mahendra Parikh, M.D. (who has been a practicing radiologist and serving the community of Dover for 30 years).

Testimonials:
“After years of mammograms at other facilities, I was unbelievably pleased with my experience at MDI where the Radiologist actually spoke to me about my mammogram and answered all of my questions. I had never met the Radiologist who read my scans before MDI and I will be back next year.”

“The staff at MDI is exceptionally pleasant and knowledgeable. This is always a high anxiety moment for me and the technologists and Dr. Parikh always put me at ease, year after year. I will always continue to go to MDI for my mammograms and will bring my family and friends there for any x-ray exam they may need.”