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Skip to content AboutNews/In the MediaSiteman Cancer Center ranked No. 10 among U.S. cancer centersSiteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine has been named No. 10 among cancer centers nationally by U.S. News & World Report. The recognition is part of the overall ranking&＃8230;Read The Full Story Mission, Vision &＃038; History Why Siteman Diversity, Equity &＃038; Inclusion at SitemanAboutDiversity, Equity &＃038; Inclusion at SitemanLearn More Leadership Organizations Committees Partnerships Contact This is Cancer Learning With National Leaders In the News TreatmentClinicalHow Siteman is leading the way in personalized brain tumor treatmentIf you or a loved one have recently been diagnosed with a brain tumor, you likely feel a great deal of fear and have many questions. The brain is the epicenter of who we are,&＃8230;Read The Full Story Physician Directory Clinical Trials Search Patient Experience Siteman Psychology Service Survivorship Cardio-Oncology Lymphedema Surgery NCI Cancer Information A to Z Treatment Roles Cancer Types Bladder Brain Breast Cervical Childhood Cancers Colorectal Young Onset Colorectal Esophageal Gallbladder Head/Neck Kidney Leukemia Liver Lung Lymphoma Multiple Myeloma Myelodysplastic Syndromes (MDS) Ovarian Pancreatic Prostate Sarcoma/Rare Tumors Skin Stomach Testicular Thyroid Uterine The Siteman Approach Medical Therapy Expertise in Radiation Oncology Surgery Genetics and Hereditary Cancer Cancer Imaging Immunology and Immunotherapy Pathology Patient and Family Services Specialized Programs Stem Cell Transplant and Cellular Therapies Center Gynecologic Oncology Brain Tumor Center Sarcoma VisitingNews/In the MediaSiteman Cancer Center expands proton therapy treatmentSiteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine is expanding proton therapy for patients by adding the latest, most innovative technology to its S. Lee Kling Proton Therapy Center with the addition of&＃8230;Read The Full Story Patient and Family Services Washington University Medical Campus West County St. Charles County South County Siteman Kids at St. Louis Children’s Hospital North County Illinois Siteman Cancer Network Cancer Care Clinic Barnard Health and Cancer Information Center Pharmacies Payment Information &＃038; Assistance Patient Rights Patient Privacy PreventionPreventionSiteman explains what every woman should know about endometrial cancer risk, symptoms and screeningEndometrial cancer is the fourth most common cancer for women in the United States. It also accounts for approximately 4 percent of cancer deaths in women. However, because it is usually diagnosed early, it is&＃8230;Read The Full Story Your Disease Risk® Preventing Cancer Risk Factors Screening Smoking Cessation Mammography Genetic Counseling Cancer News in Context 8IGHTWAYS® to Prevent Cancer Health Disparities Community Outreach and Engagement ResearchResearchImmunity boosting treatment enhances CAR-T cell therapy for blood cancersAdvances in cellular immunotherapy that spur genetically modified T cells to attack cancer cells have revolutionized the treatment of certain blood cancers. Six such CAR-T cell therapies are approved by the Food and Drug Administration&＃8230;Read The Full Story List of Researchers Significant Research Advances Learn About Clinical Trials Membership Information Plan to Enhance Diversity (PED) Research Programs Funding Opportunities Training &＃038; Education Shared Resources (Cores) Resources for Researchers SPORE in Pancreatic Cancer SPORE in Endometrial Cancer SPORE in Leukemia Center for Genome Integrity CliniciansNews/In the Media$5.3 million grant supports research into lung cancer recurrenceResearchers at Washington University School of Medicine in St. Louis are leading a national study aimed at identifying patients with early-stage lung cancer who are at high risk of having the cancer return, even after&＃8230;Read The Full Story Physician Services Educational Programs GiveNews/In the MediaCouple honors physician with gift for distinguished professorshipEndowment will support leader in gynecologic oncology Financial adviser Elizabeth Mannen Berges lives each day with heightened gratitude for the basic components of a meaningful life—fulfilling work, caring relationships, and a sense of purpose. A&＃8230;Read The Full Story Siteman Advancement Office Volunteering and Contributing The Foundation for Barnes-Jewish Hospital AboutNews/In the MediaSiteman Cancer Center ranked No. 10 among U.S. cancer centersSiteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine has been named No. 10 among cancer centers nationally by U.S. News & World Report. The recognition is part of the overall ranking...Read The Full StoryAboutNews/In the MediaSiteman Cancer Center ranked No. 10 among U.S. cancer centersSiteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine has been named No. 10 among cancer centers nationally by U.S. News & World Report. The recognition is part of the overall ranking...Read The Full StoryMission, Vision & HistoryWhy SitemanDiversity, Equity &＃038; Inclusion at SitemanAboutDiversity, Equity &＃038; Inclusion at SitemanLearn MoreLeadershipOrganizationsCommitteesPartnershipsContactThis is CancerLearning With National LeadersIn the NewsTreatmentClinicalHow Siteman is leading the way in personalized brain tumor treatmentIf you or a loved one have recently been diagnosed with a brain tumor, you likely feel a great deal of fear and have many questions. The brain is the epicenter of who we are,...Read The Full StoryTreatmentClinicalHow Siteman is leading the way in personalized brain tumor treatmentIf you or a loved one have recently been diagnosed with a brain tumor, you likely feel a great deal of fear and have many questions. The brain is the epicenter of who we are,...Read The Full StoryPhysician DirectoryClinical Trials SearchPatient ExperienceSiteman Psychology ServiceSurvivorshipCardio-OncologyLymphedema SurgeryNCI Cancer Information A to ZTreatment RolesCancer TypesCancer TypesBladderBrainBreastCervicalChildhood CancersColorectalYoung Onset ColorectalEsophagealGallbladderHead/NeckKidneyLeukemiaLiverLungLymphomaMultiple MyelomaMyelodysplastic Syndromes (MDS)OvarianPancreaticProstateSarcoma/Rare TumorsSkinStomachTesticularThyroidUterineThe Siteman ApproachThe Siteman ApproachMedical TherapyExpertise in Radiation OncologySurgeryGenetics and Hereditary CancerCancer ImagingImmunology and ImmunotherapyPathologyPatient and Family ServicesSpecialized ProgramsSpecialized ProgramsStem Cell Transplant and Cellular Therapies CenterGynecologic OncologyBrain Tumor CenterSarcomaVisitingNews/In the MediaSiteman Cancer Center expands proton therapy treatmentSiteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine is expanding proton therapy for patients by adding the latest, most innovative technology to its S. Lee Kling Proton Therapy Center with the addition of...Read The Full StoryVisitingNews/In the MediaSiteman Cancer Center expands proton therapy treatmentSiteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine is expanding proton therapy for patients by adding the latest, most innovative technology to its S. Lee Kling Proton Therapy Center with the addition of...Read The Full StoryPatient and Family ServicesWashington University Medical CampusWest CountySt. Charles CountySouth CountySiteman Kids at St. Louis Children’s HospitalNorth CountyIllinoisSiteman Cancer NetworkCancer Care ClinicBarnard Health and Cancer Information CenterPharmaciesPayment Information &＃038; AssistancePatient RightsPatient PrivacyPreventionPreventionSiteman explains what every woman should know about endometrial cancer risk, symptoms and screeningEndometrial cancer is the fourth most common cancer for women in the United States. It also accounts for approximately 4 percent of cancer deaths in women. However, because it is usually diagnosed early, it is...Read The Full StoryPreventionPreventionSiteman explains what every woman should know about endometrial cancer risk, symptoms and screeningEndometrial cancer is the fourth most common cancer for women in the United States. It also accounts for approximately 4 percent of cancer deaths in women. However, because it is usually diagnosed early, it is...Read The Full StoryYour Disease Risk®Preventing CancerRisk FactorsScreeningSmoking CessationMammographyGenetic CounselingCancer News in Context8IGHTWAYS® to Prevent CancerHealth DisparitiesCommunity Outreach and EngagementResearchResearchImmunity boosting treatment enhances CAR-T cell therapy for blood cancersAdvances in cellular immunotherapy that spur genetically modified T cells to attack cancer cells have revolutionized the treatment of certain blood cancers. Six such CAR-T cell therapies are approved by the Food and Drug Administration...Read The Full StoryResearchResearchImmunity boosting treatment enhances CAR-T cell therapy for blood cancersAdvances in cellular immunotherapy that spur genetically modified T cells to attack cancer cells have revolutionized the treatment of certain blood cancers. Six such CAR-T cell therapies are approved by the Food and Drug Administration...Read The Full StoryList of ResearchersSignificant Research AdvancesLearn About Clinical TrialsMembership InformationPlan to Enhance Diversity (PED)Research ProgramsFunding OpportunitiesTraining &＃038; EducationShared Resources (Cores)Resources for ResearchersSPORE in Pancreatic CancerSPORE in Endometrial CancerSPORE in LeukemiaCenter for Genome IntegrityCliniciansNews/In the Media$5.3 million grant supports research into lung cancer recurrenceResearchers at Washington University School of Medicine in St. Louis are leading a national study aimed at identifying patients with early-stage lung cancer who are at high risk of having the cancer return, even after...Read The Full StoryCliniciansNews/In the Media$5.3 million grant supports research into lung cancer recurrenceResearchers at Washington University School of Medicine in St. Louis are leading a national study aimed at identifying patients with early-stage lung cancer who are at high risk of having the cancer return, even after...Read The Full StoryPhysician ServicesEducational ProgramsGiveNews/In the MediaCouple honors physician with gift for distinguished professorshipEndowment will support leader in gynecologic oncology Financial adviser Elizabeth Mannen Berges lives each day with heightened gratitude for the basic components of a meaningful life—fulfilling work, caring relationships, and a sense of purpose. A...Read The Full StoryGiveNews/In the MediaCouple honors physician with gift for distinguished professorshipEndowment will support leader in gynecologic oncology Financial adviser Elizabeth Mannen Berges lives each day with heightened gratitude for the basic components of a meaningful life—fulfilling work, caring relationships, and a sense of purpose. A...Read The Full StorySiteman Advancement OfficeVolunteering and ContributingThe Foundation for Barnes-Jewish Hospital Request an Appointment Request an Appointment For help choosing a doctor or making an appointment, please complete our form or call us directly. (800) 600-3606 I am a: Patient / New Patient Caregiver Physician Menu The Siteman Approach The Siteman Approach Surgery Surgery Options Expertise in Radiation Oncology Our Radiation Oncology Team External-Beam Radiation Therapy 3D Conformal Radiation Therapy Intensity-Modulated Radiation Therapy Stereotactic Body Radiation Therapy (SBRT and Stereotactic Radiosurgery (SRS) Adaptive Radiation Therapy Gamma Knife Proton Beam Therapy Brachytherapy Hyperthermia Therapy Systemic Radiation Therapy Side Effects of Radiation Therapy Medical Therapy Scalp Cooling Cancer Imaging Pathology Genetics and Hereditary Cancer Immunology and Immunotherapy What's on this page History of Excellence Tomosynthesis (3D mammography) Positron emission tomography (PET) PET-CT Spiral CT/CT SPECT MRI PET/MRI Ultrasound Cancer Goggles Mallinckrodt Institute of Radiology | Treatment | The Siteman Approach | Cancer Imaging Cancer Imaging In recent years, the technology available to help physicians detect and diagnose cancer has changed dramatically. More than half of the clinical imaging tools used by Siteman Cancer Center clinicians today to take images of tumors and cancer cells had not been fully developed or did not exist 35 years ago. These advances help radiologists. X-ray, which produces images of specific parts of the body, is the oldest and still most frequently used imaging. When the detail of X-ray is not enough, state-of-the-art imaging systems get them the information they need. At Siteman, clinical expertise in diagnostic imaging comes from the acclaimed faculty of Mallinckrodt Institute of Radiology (MIR) at Washington University School of Medicine, an international leader in the imaging of cancer and other diseases and disorders. MIR offers the latest imaging tools for cancer. No other local radiology group is better trained to read your imaging exam. Mallinckrodt radiologists are nationally and internationally recognized for their expertise. They are leaders in the field, editors for professional journals and are subspecialty trained. This means they have additional training and expertise in imaging specific organs and body systems. Because that is all they do, they know how to interpret the subtleties of a scan or other imaging tests and see what others may miss. Subspecialization also means that their interpretation is more detailed and specific, and apt to be more helpful in determining the course of treatment. Their expertise helps you avoid unnecessary imaging exams that can increase your exposure to radiation. Three-dimensional technology has been applied to many imaging types to enhance existing images and increase the amount of detail available for diagnosis. Similarly, nuclear medicine can enhance the information obtained from different imaging techniques, such as CT, X-ray, and MRI (see below). Nuclear medicine exams assess the function of organs by using small amounts of radioactive material (radiopharmaceuticals) and a special camera to create images.  The radiopharmaceutical is either taken by mouth or injected into the vein and is designed to go to a specific place in the body where there could be disease or an abnormality and is drawn to specific organs, bones or tissues.  These areas of the body then emit gamma rays that are detected by the camera. Because nuclear medicine procedures are able to pinpoint molecular activity within the body, they offer the potential to identify disease in its earliest stages, as well as a patient&＃8217;s immediate response to treatment. History of Excellence The Joanne Knight Breast Health Center at Barnes-Jewish Hospital is one of the original Breast Imaging Centers of Excellence as designated by the American College of Radiology and its radiologists interpret more than 50,000 exams annually. The most up-to-date digital images and imaging techniques are read by breast imaging specialists to get the information doctors need to accurately diagnose and treat a specific cancer.The Breast Health Center offers mammography (screening and diagnostic), tomosynthesis (3D mammography), breast ultrasound and breast magnetic resonance imaging (MRI), as well as image-guided biopsies and needle localizations. The most specialized exams and procedures are available at the Joanne Knight Breast Health Center at the Siteman Cancer Center. Mammography is offered at satellite locations and in a mobile mammography van. Images are all digital for a more accurate diagnosis. Washington University radiologist at Siteman are pioneers in the development of a machine combining two often-used types of scanning – PET/CT. It provides high-quality images of body structures — as well as cancer activity in the cells — at the same time in a single scan. Because the scan reveals so much detail, it can pinpoint the smallest cancer that has metastasized, or spread, to other parts of your body. Treatment can then target the cancer in a way that will cause the least amount of damage possible to the rest of the body. Similarly, Mallinckrodt had one of the first PET/MR scanners in the world. MRI (magnetic resonance imaging) offers excellent contrast among soft tissues while PET (positron emission tomography) offers excellent images of molecular activity within the body. Therefore, the combination of PET and MRI provides many advantages to the patient for modern medical diagnosis. In the last year, Mallinckrodt Institute of Radiology has performed: 793,757 diagnostic examinations 14,255 nuclear medicine examinations 52,805 interventional radiology procedures Tomosynthesis (3D mammography) The Breast Health Center is now an all-tomosynthesis site. Tomosynthesis, or 3-D mammography, captures images of the breast from multiple angles. The breast is positioned the same way it is in a conventional mammogram, but only a little pressure is applied — just enough to keep the breast in a stable position during the procedure. The X-ray tube moves in an arc around the breast while 11 images are taken during a 7-second examination. Then the information is sent to a computer, where it is assembled to produce clear, highly focused 3-dimensional images throughout the breast. The call-back rate for additional scans has been reduced by up to 40 percent because radiologists receive all the views they need the first time. Positron emission tomography (PET) Developed by MIR researchers in 1972, PET captures tumor cells in action. It is widely used to evaluate patients with various cancers, including esophageal cancer, lung cancer and colorectal cancer. It accurately gauges the severity and spread of cancer by revealing the metabolic activity of tissues using small amounts of a radioactive compound. In some cases, PET imaging gives radiologists a way to detect cancer in early, more treatable stages – sometimes months before a tumor becomes evident through other forms of diagnostic testing. It can also be used to track tumor response to treatment so if a particular treatment is not effective, it can be changed sooner to something more effective. PET-CT PET/CT provides high-quality images of body structures — as well as cancer activity in the cells — at the same time in a single scan. Because the scan reveals so much detail, it can pinpoint the smallest cancer that has metastasized, or spread, to other parts of your body. Treatment can then target the cancer in a way that will cause the least amount of damage possible to the rest of the body. Spiral CT/CT Mallinckrodt Institute had the one of the first CT scanners in North America, and continues to refine and expand applications for this technology. CT is an X-ray procedure that uses a computer to produce a detailed image of a cross-section of the body in thin slices. CT images help verify the presence of kidney and pancreatic cancer, among others.  These scanners are also being used at MIR to detect colorectal polyps, which are precancerous growths of the colon. Two-dimensional colonography images are obtained that are then transferred to a specialized computer workstation, where a 3D rendering of the torso is created.  Similar 3DCT techniques are used to evaluate the blood vessels and the urinary tract. SPECT A single photon emission computed tomography (SPECT) scan is a type of nuclear imaging test that shows how blood flows to tissues and organs.  A SPECT scan integrates two technologies to view your body:  computed tomography (CT) combined with a radioactive material or tracer. Before the SPECT scan, a patient is injected with the tracer.  A computer collects the information emitted by gamma rays and translates them into two-dimensional and three dimensional images for interpretation by a Nuclear Medicine radiologist. This technique is used at MIR to determine whether tumor cells in women with breast cancer have an abundance of the protein p-glycoprotein. Women whose tumor cells are covered with this protein may be poor candidates for chemotherapy, and knowing this allows doctors to switch to other forms of treatment. MRI Magnetic resonance imaging (MRI) is a noninvasive medical test that helps physicians diagnose and treat medical conditions.  It uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures — all without any radiation exposure.  MRI provides very detailed information that is not always visible using other methods.  The images can then be examined on a computer monitor by a radiologist.  Because of the sharp detail it provides, MRI is a mainstay for viewing the complex anatomy of the brain and detecting tumors there and in other internal organs. Detailed MR images allow physicians to evaluate various parts of the body and determine the presence of certain diseases.   Certain subsets of MRI are moving cancer treatment along in other ways:   Functional MRI (brain mapping): Mapping the brain is critical for neurosurgeons who not only want to get a detailed fix on areas targeted for surgery but also need to minimize the risks of surgical damage to healthy brain regions that perform essential tasks. Never is this more critical than in the brain and spinal cord. For many years, neurosurgeons have accomplished the job using a time-intensive approach called functional magnetic resonance imaging (fMRI). Patients perform several simple tasks—saying their name or moving an arm, for example—while their brain is repeatedly scanned. Researchers have now discovered that resting state fMRI is also useful for precisely mapping all of an individual patient’s critical brain networks: speech, motor control and others in one session while the patient lies in the scanner and rests. Intraoperative MRI: In the operating room, with the data from the genetic tumor map and the functional MRI, the surgery can commence. However, as a tumor is removed and cerebrospinal fluid drained, the map becomes inaccurate for tumor margins. That’s where real-time intraoperative MRI (iMRI) comes in to give the surgeons the updated information to complete the surgery accurately. A mobile MRI machine located between two surgical suites can be moved into either operating room as needed to remap the remaining tumor. MRI-Guided laser interstitial therapy: Washington University neurosurgeons are among the first in the nation to use an MRI-guided, high-intensity laser probe designed especially for the treatment of inoperable brain tumors to &＃8220;cook&＃8221; cancer cells deep within the brain while leaving surrounding brain tissue undamaged. Patients who are candidates for this procedure have a small burr hole the diameter of a pencil drilled through their skull. Neurosurgeons then use real-time MR imaging to guide the probe through the brain and into the tumor. Once inside the tumor, the laser discharges highly focused heat energy to coagulate and kill cancer cells. The technology is FDA-approved for several types of brain tumors and metastatic cancers that have spread from other regions of the body, some radiation-resistant tumors, and radiation necrosis due to prior radiation therapy. PET/MRI Simultaneous PET/MRI is used when the information from both modalities is needed for diagnosis or tumor staging. Tumors that are well-evaluated by MRI, like cervical, ovarian or endometrial for women and colorectal cancers in men and women, are good candidates. Liver tumors or other cancers that have metastasized to the liver lend themselves well to the new technology because MRI-can outline the shape and appearance of the tumors and PET can detect distant lesions that might otherwise be missed. Washington University School of Medicine and Mallinckrodt Institute of Radiology opened the first clinical service in Missouri offering simultaneous PET/MRI in 2014. Ultrasound Ultrasound is safe and painless, and produces pictures of the inside of the body using sound waves. Ultrasound imaging, also called sonography, involves the use of a small probe and ultrasound gel placed directly on the skin or in a body orifice, such as the colon or the vagina. High-frequency sound waves are transmitted from the probe through the gel into the body. The probe collects the sounds that bounce back and a computer then uses those sound waves to create an image. Ultrasound examinations do not use ionizing radiation (as used in X-rays), so there is no radiation exposure to the patient. Because ultrasound images are captured in real-time, they can show the structure and movement of the body&＃8217;s internal organs, as well as blood flowing through blood vessels.  Conventional ultrasound displays the images on computer monitors for interpretation by a radiologist.  Mallinckrodt has the most advanced ultrasound technology available, including three-dimensional (3-D) ultrasound that formats the sound wave data into 3-D images. Endoscopic Ultrasound: A variation of ultrasound, endoscopic ultrasound involves the use of a probe on the end of a fiber-optic endoscope to look at intestinal abnormalities. It allows physicians to differentiate between tumors, cysts and stones in the bile duct, pancreas and other abdominal organs. Endoscopic ultrasound also can visualize rectal tumors and determine whether they have spread. Doppler ultrasound is a special type of ultrasound that evaluates blood speed as it flows through a blood vessel. This type of ultrasound is used to view the veins and arteries of the abdominal organs as well as other vessels throughout the body. Cancer Goggles Mallinckrodt&＃8217;s Optical Radiology Laboratory developed wearable technology that helps surgeons more clearly visualize cancer cells. These high-tech glasses make cancer cells glow blue when viewed through the eyewear. Cancer cells are notoriously difficult to see, even under high-powered magnification. The glasses are designed to make it easier for surgeons to distinguish cancer cells from healthy cells, helping to ensure that no stray tumor cells are left behind during surgery. So far, the goggles have been tested in breast cancer, pancreatic cancer and melanoma surgery. They are not yet available as a standard of care. Mallinckrodt Institute of Radiology To learn more about the Mallinckrodt Institute of Radiology at Washington University School of Medicine, please visit their website https://www.mir.wustl.edu/. Contact 800-600-3606 Email Subscribe for Siteman Updates X-twitter Facebook Youtube Linkedin Instagram Careers Washington University Barnes-Jewish Hospital Locations Washington University Medical Campus West County St. Charles County South County North County Illinois Copyright © 2015 - 2024 All rights reserved.