Diagnostic Testing

Comprehensive Pain Management Services

Pathology

64- Slice CT

Advanced Gastroenterological Services

The physicians at the Gastrointestinal Center of New Jersey provide advanced screening and diagnostic gastroenterological services including the following:

  • Screening EGD and colonoscopy

  • Advanced diagnostic modalities

  • Push pull enteroscopy

  • Capsule enteroscopy

  • Endoscopic mucosal resection (EMR)

  • Endoscopic retrograde cholangiopancreatography (ERCP)

  • Sphincterotomy, Ampullectomy with biliary and pancreatic stenting

  • Pancreatic coring and biopsy

  • Endoscopic ultrasound and biopsy/sampling

  • Spyglass cholangioscopy and biopsy

  • Transrectal ultrasound

  • MRI staging modalities

  • Manometric methodology

Barium Swallow Testing

Barium Swallow Testing is digestive system diagnostic test that is used to visualize the esophagus and evaluate an individual’s swallow reflex. Because the esophagus is not visible on x-rays, barium is given which coats the esophagus to allow visualization with the use of x-rays. The individual drinks the barium preparation which is a chalky like drink with the consistency of milk. X-rays are taken to visualize the esophagus and to identify any abnormalities within the structure or with the function of swallowing.

Capsule Endoscopy

This procedure does not actually use an endoscope nor require a trip to the hospital. Instead, the patient swallows a capsule (about the size of a large vitamin pill) that contains a light source and a very small camera. Like any other pill, the capsule goes through the stomach and into the small intestine. During its travels it photographs the digestive system. The capsule/camera transmits images to a device that is worn by the individual. The physician downloads the pictures from the devise and then analyzes the results. The capsule is excreted during a normal bowel movement and is flushed away.

Colonoscopy

Colonoscopy is currently considered the best method available for detecting polyps and cancers in the colon and rectum. Cancer in the colon usually takes years to develop from the first abnormal cell. Regular colonoscopy is the best way to prevent the disease from developing. A colonoscopy is a procedure where a long flexible scope equipped with a video is inserted into the entire length of the colon allowing the physician to visualize the colon. During the exam, the physician will be to see changes in lining or any growths within the colon. Small growths, also known as polyps will be removed and sent to a laboratory for further examination. Larger growths will also be tested but may require additional follow up and surgery.

Colonoscopy is recommended every ten years beginning at age 50. Individuals with a family history or other risk factors for colorectal polyps or cancer, such as inflammatory bowel disease, should talk with their doctor about starting screening at a younger age and/or getting screened more frequently.

Double Balloon Enteroscopy

Similar to an endocsopy, this digestive system diagnostic test uses two tubes an endoscope and balloon. Through the use of the balloon and the endoscope, the doctor is able to move farther into the small intestine to visualize any problems and perform biopsy areas as needed.

Endoscopic Ultrasound (EUS)

Endoscopic Ultrasound combines the technology of endoscopy with ultrasound. In a traditional ultrasound, the transducer is placed on the specific area and sound waves are transmitted which produce a picture of the area. These pictures, although good for many purposes are not as detailed as those obtained from an Endoscopic Ultrasound. A physician orders this test to obtain detailed images of the digestive tract and structures/organs inside the body.

The digestive system diagnostic test is performed with an endoscope (long tube) which is equipped with a transducer on the tip. Depending on the type of test and the area of concern, the endoscope will be used to obtain images of your upper digestive tract, esophagus, stomach and duodenum or the colon and rectum. By inserting the Endoscope into the body, either through the mouth or the rectum, it can get closer to the organs and structures of interest within the body. The ultrasound allows improved visualization of the area including the lining of the intestines as well as adjacent lymph nodes and blood vessels.

Endoscopic ultrasound is often used for the following:

  • Staging of cancers of the lung, esophagus, stomach, pancreas and rectum.
  • Evaluating growths in the esophagus, stomach or surrounding areas.
  • Evaluating chronic pancreatitis and other masses or cysts of the pancreas.
  • Studying bile duct abnormalities including stones in the bile duct or gallbladder, or bile duct, gallbladder, or liver tumors.
  • Studying the muscles of the lower rectum and anal canal in evaluating reasons for fecal incontinence.
  • Studying 'submucosal lesions' such as nodules or 'bumps' that may be hiding in the intestinal wall covered by normal appearing lining of the intestinal tract.

Enteroclysis

This is a way to look at the small intestine. For this procedure, a tube is passed from the nose or mouth through the stomach and into the small intestine. Then, barium is sent through the tube directly into the small intestine. X-rays are taken as the contrast travels through the small bowel.

Heated Intraperitoneal Chemotherapy

Heated Chemotherapy Offers Advance Abdominal Cancer Patients Longer Life

Until recently, treatment options for patients with advanced abdominal cancers could only provide relief from symptoms, with no hope of stopping the disease from recurring or prolonging life.

Now, with the use of heated intraperitoneal chemotherapy using the FDA-approved ThermoChem(TM) HT-1000 System, surgeons at Saint Barnabas have the potential to dramatically improve the outlook for late-stage patients with colon/rectal cancer, ovarian/uterine cancer, cancer of the small bowel, and pseudomyxoma peritonei syndrome, a rare malignant disorder.

The potent combination of heat, chemotherapy and specialized surgery offers an extended outlook for patients with otherwise untreatable abdominal cancers, most of whom have been given three to six months to live. The specialized system reports response rates of up to 25 percent of patients achieving a greater than two year survival rate.

This new technology allows surgeons to direct a heated sterile solution throughout the entire abdomen, a treatment commonly referred to as Intraperitoneal Hyperthermia (IPH) or Heated Chemotherapy.

What is Heated Chemotherapy?

ThermoChem(TM) is the first and only FDA approved device for IPH. Surgeons use IPH in conjunction with a lengthy 8-10 hour surgery, removing as many tumors as possible from the abdominal cavity. Then, two small incisions are made and tubes are inserted, one to pump the heated chemotherapy into the patient and the other to circulate it back into the machine. The chemotherapy circulates for approximately two hours.

How Does Heated Chemotherapy Work?

Heat kills cancer cells at temperatures where normal cells remain unharmed. Heating the chemotherapeutic agents makes them more effective at killing cancer cells than they would be at normal temperatures. Circulating the heated chemotherapy throughout the peritoneal and abdominal cavity allows the drugs to be distributed thoroughly and penetrate directly, without subjecting you to the side effects of these drugs if given intravenously.

Is Heated Chemo Right for You?

Because such surgery is a major procedure that is not without risk and because the recovery can be substantial, Heated Chemotherapy is not for everyone. To find out if you are a candidate, please contact 973-322-5195 to make an appointment with a surgeon at Saint Barnabas.

Magnetic Resonance Imaging (MRI)

Magnetic Resonance Imaging (MRI) is a highly advanced diagnostic test that provides detailed images of the body. It uses a large magnet, radio waves and a computer to scan your body and produce particularly clear pictures that cannot be seen on conventional X-rays. Combined, the Saint Barnabas Medical Center and the Saint Barnabas Ambulatory Care Center have a total of four MRI’s (including an open MRI), offering a full spectrum of MRI Services; including, MRCP (magnetic resonance cholangiopancreatography) that replaces the traditional endoscope for the detection of biliary disease.

PET/CT

PET/CT is a multi-functional diagnostic tool which combines two scanning techniques – the PET (Positron Emission Tomography), which shows functional activity in the body, and the CT (Computed Tomography), which shows detailed structural anatomy. The PET/CT scan permits accurate tumor detection and localization for a variety of cancers, including melanoma, lymphoma, lung, colorectal, head and neck, and ovarian cancers. The enhanced imaging tools can also provide early detection of the recurrence of cancers, revealing tumors that may otherwise be obscured by the scaring that results from surgery and radiation therapy.

Radiology

  • Largest Department in New Jersey

  • State of the Art Technology

  • Interventional Radiology

  • Ultrasound

  • CT

  • MRI

  • PET

  • SPECT

  • Nuclear Medicine

  • Organ directed contrast studies

Selective Internal Radiation Therapy (SIRT) Using Yttrium-90

Saint Barnabas Medical Center is the first hospital in New Jersey and one of only 15 major medical centers in the country to offer this new and innovative protocol for the treatment of metastatic liver cancer through intra-arterial radiation therapy or Selective Internal Radiation Therapy (SIRT). This therapy is indicated for inoperable patients with liver cancer or metastases. SIRT is a new tool in the treatment of tumors of the liver and has proved to have many advantages over conventional external radiation and helping prolong and improve the quality of life in such patients.

“Compared with traditional radiation or chemotherapy, the treatment appears to have low level of side effects. We at Saint Barnabas are pleased to be able to offer SIRT as another potential treatment for patients with liver tumors. As the most comprehensive multi-disciplinary Gastrointestinal Cancer Center in New Jersey, SIRT will be incorporated into the individualized care plan we put together for each patient.” explains Ronald Chamberlain, MD, MPA, FACS, Chairman of the Department of Surgery and Director of the Gastrointestinal Cancer Center of the Saint Barnabas Medical Center.

Unlike conventional external radiation beams that can only be applied to limited areas of the body, Chamberlain says that SIRT has the ability to deliver more potent doses of radiation directly to the cancer cells over a longer period of time. For a small number of patients, SIRT can cause enough shrinkage of the tumors allowing for surgical removal at a later date.

How Does SIRT Work?

The technique uses millions of tiny polymer (plastic) beads or microspheres which contain a radioactive element called yttrium-90. The spheres are inserted into the liver via a catheter and carried by the bloodstream directly to the tumors in the liver where they preferentially lodge in the small vessels feeding the tumor and deliver their dose of radiation for a period of approximately two weeks. Because the high dose of radiation from the spheres is selectively delivered to the tumor, other parts of the body usually are not affected.

“It’s a highly targeted treatment injected right into the liver. The risk to normal tissue is extremely low,” explains Raquel Wagman, M.D., radiation oncologist, who along with Dr. Chamberlain and radiologist Cornelius McCarthy, M.D. and Michael Kaplan, forms the multidisciplinary treatment team.

The procedure to deliver the spheres is short and done with local anesthesia; it usually does not require an overnight hospital stay.

Is SIRT Right for You?

To find out if you are a candidate for SIRT, please contact the Gastrointestinal Cancer Center of New Jersey at Saint Barnabas, (973) 322-5550, to make an appointment.

Ultrasound

Ultrasound is a test that uses sound waves to create pictures of the organs inside the body. The test is non invasive. The individual will lie on the table. Gel may be put on the abdomen or onto the wand which is placed on the abdomen. An image is transmitted to the machine which is generally adjacent to the patient.