HOW DOES ULTRASOUND HELP DETERMINE IF A LUMP IS A CONCERN?

Although they are usually harmless, finding a lump can be concerning. The most common types of lumps are cysts and tumours. A cyst is a small sac filled with air, fluid, or other material. A tumour is an unusual area of extra tissue. Both can be found in your skin, tissue, organs, and bones.

It’s important to determine what type of lump you have since cysts are mostly benign, while tumours can be either benign or malignant. Benign tumors tend to stay in one place, but malignant tumors can spread to other parts of your body.

HOW DOES ULTRASOUND SEE INTO LUMPS?

Ultrasound imaging can help determine the composition of lumps, distinguishing between a cyst and a tumour. Also known as sonography, it involves the use of high-frequency, real-time sound waves to create an image. A small transducer (probe) both transmits sound waves into the body and records the waves that echo back. Sound waves travel into the area being examined until they hit a boundary between tissues, such as between fluid and soft tissue, or soft tissue and bone. At these boundaries some of the sound waves are reflected back to the probe, while others travel further until they reach another boundary and are reflected back. Since the pitch, direction, and distance sound waves travel differ depending on the boundary they run into, a computer can interpret this information as a two-dimensional image on a screen.

The shape and intensity of the echoes depend on whether the area absorbs or transmits the sound waves. For example, most waves pass through a fluid-filled cyst and send back very few or faint echoes, which look black on the display screen. On the other hand, waves will bounce off a solid tumor, creating a pattern of echoes that the computer will interpret as a lighter-colored image. Air and bone also reflect sound waves.

Most tumours are benign. Ultrasound can usually help differentiate between benign and malignant tumours based on shape, location, and a number of other sonographic characteristics. If the ultrasound is inconclusive, your doctor may request follow-up ultrasound to monitor the tumor or a radiologist may recommend a biopsy.

A biopsy can be performed in cases where ultrasound cannot differentiate benign from malignant tumours. This involves the insertion of a needle into the tumour to take a small tissue sample, which is then sent to a laboratory for analysis.

WHAT HAPPENS DURING MY EXAM?

Ultrasound helps health care practitioners make a diagnosis and inform care decisions. Once your doctor has identified the need for an ultrasound, your doctor’s office may book an appointment for you, or provide you with a number to call to book your appointment. You will also be given a requisition form and preparation instructions for your exam.

Depending on the area to be examined, you may be asked to arrive with a full bladder or to fast and have nothing to eat or drink (except water) for six hours prior to your exam.

Once in the exam room you may be asked to change into a gown. You will then be positioned by one of our compassionate and experienced sonographers. A warm, unscented, hypo-allergenic, water-based ultrasound gel will be applied to the area of concern, and your sonographer will move the transducer around to gather images of your organs. You may be asked to hold your breath and change position to help better examine the area of concern. You may experience mild to moderate pressure while the sonographer takes the images.

WHAT HAPPENS AFTER MY EXAM?

Your images will be reviewed by a specialized radiologist who will compile a report that is sent to your doctor within 24 hours, sooner for urgent requests. Mayfair Diagnostics is owned and operated by over 50 radiologists who are fellowship-trained in many key areas, such as neuroradiology, body, cardiac, musculoskeletal, etc. This allows for an expert review of your imaging by the applicably trained radiologist.

Your images will be uploaded to a provincial picture archiving and communication system (PACS) – this technology provides electronic storage and convenient access to your medical images from multiple sources, such as your doctor, specialists, hospitals, and walk-in clinics.

Your doctor will review your images and the report from the radiologist and discuss next steps with you, such as a treatment plan or the need for further diagnostic imaging or lab tests to ensure an accurate diagnosis.

Mayfair Diagnostics has 13 locations across Calgary which offer ultrasound services, as well as one in Cochrane and one in Regina. For more information, please visit our ultrasound services page.

REFERENCES

American Cancer Society (2015) “Ultrasound for Cancer.” www.cancer.org. Accessed August 23, 2022.

National Institute of Biomedical Imaging and Bioengineering (2016) “What is medical ultrasound?” www.nibib.nih.gov. Accessed August 23, 2022.

Nordqvist, C. (2017) “How do ultrasound scans work?” www.medicalnewstoday.com. Accessed August 23, 2022.

O’Keefe Osborn, C. (2018) “What’s the Difference Between Cysts and Tumors?” www.healthline.com. Accessed August 23, 2022.

Radiological Society of North America (2020) “General Ultrasound.” www.radiologyinfo.org. Accessed August 23, 2019.