Diagnostic Imaging: The Diagnostic Imaging service uses a variety of equipment such as x-rays, ultrasound and MRI to produce images to help diagnose medical and surgical problems in our patients.

Consultants:

Sam Jakovljevic DMV MSc DVR DipECVDI MRVCS

  • European Diplomate in Veterinary Diagnostic Imaging
  • Head of Diagnostic Imaging

Abby Caine MA VetMB DipECVDI CertVDI MRCVS

  • European Specialist in Veterinary Diagnostic Imaging

Inma Ferrandis DVM CertVDI MRCVS

The Diagnostic Imaging Service is headed by Sam Jakovljevic, assisted by Consultant Radiologists Abby Caine, Inma Ferrandis and ECVDI Resident Roberto Tapia Nieto, our MRI radiographer Sue Bravo Rodriguez, our nurse radiographer Tammy Robinson, and our nurse co-ordinator Jemma Johnson.

The Diagnostic Imaging team combines experience, expertise and a team approach to the diagnosis of medical problems in pets treated at DWR. Our primary objective is to fully support each of our specialist disciplines, assisting our colleagues in the diagnosis and treatment of our patients, using state of the art equipment.  We are also able to perform minimally invasive procedures, such as fine needle aspirations or biopsies of diseased organs. We give advice to veterinary surgeons in general practice who require help for any aspect of Diagnostic Imaging, and for interpretation of their radiological examinations.
In order to provide the best diagnostics possible, we use state of the art equipment. Our magnetic resonance scanner provides high quality images, without the use of radiation which is a characteristic of x-rays. MRI scans are particularly useful in the diagnosis of cancer as well as neurological problems and some orthopaedic conditions.

We have considerable experience and expertise in diagnostic ultrasonography. Ultrasound is a safe and painless procedure which allows sound waves to be reflected by internal body structures, creating "echoes" that are converted into images. This technique is used to visualise muscles, tendons, eyes, blood vessels and many internal abdominal or thoracic organs. We have two sophisticated ultrasound machines and are able to produce images and diagnoses of the highest standard, to the benefit of all our patients.

Our X-ray facilities are fully computerised: the radiographs are directly displayed on high resolution computer monitors throughout the hospital enabling ready access to diagnostic images clinicians . This system also helps to keep patient radiation doses  to the minimum. We also fluoroscopy (real time 'video x ray') to record internal organs in motion. Sometimes, contrast substances such as barium sulphate are used to increase visibility of specific organs. For example, eating disorders can be assessed by fluoroscopic recording whilst the patient is eating a meal mixed with barium contrast. For some investigations, iodine contrastic is given intravenously and fluoroscopy is used to image the passage of blood in cardiac chambers or in the liver.

"Diagnostic imaging is essential for diagnosis and our patients benefit from such top-flight imaging facilities. Moreover, it is the expertise and experience of professional Diagnostic Imagers, not just sophisticated equipment, from which they benefit; the technology is of limited usefulness without the knowledge to use it effectively."

Dick White Referrals - Sam Jakovljevic

Sam Jakovljevic: Consultant Radiologist

DMV MSc DVR DipECVDI MRVCS

  • Honorary Associate Professor of Veterinary Diagnostic Imaging, University of Nottingham.
  • Diplomate, Royal College of Veterinary Surgeons / European College in Veterinary Radiology / Diagnostic Imaging.

Head of Diagnostic Imaging

Sam is a well-known Veterinary Radiologist who has previously held academic posts at Liège (Belgium), Bristol, Liverpool, Purdue (USA) and London University Veterinary Schools.

I graduated from the University of Liège Veterinary School in Belgium. After spending a year in general practice at one of the busiest small animal practices in Brussels, I joined the Department of Surgery and Radiology of the University of Liège Veterinary School in 1977.

I trained in Radiology at the University of Bristol Veterinary School, and spent a further year there doing clinical research, resulting in an MSc thesis investigating double contrast gastrography and gastroscopy. I was subsequently appointed as lecturer at the University of Liverpool for two years. After a few years back at University of Liège Veterinary School, I decided to join the Imaging team of the Department of Veterinary Clinical Sciences at Purdue University, Indiana USA. Ten years later, I returned to England as a Lecturer and then Senior Lecturer at the Royal Veterinary College.

Taking a pause from veterinary imaging, I worked for five years in the patent department of Cook (UK), a branch of an American medical company, before returning to clinical work as a radiologist at Dick White Referrals in January 2006. I hold the RCVS Diploma in Veterinary Radiology, and I am a European Specialist in Veterinary Diagnostic Imaging.

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Dick White Referrals - Abbie Caine

Abby Caine: Consultant Radiologist

MA VetMB DipECVDI CertVDI MRCVS

  • Honorary Associate Professor of Veterinary Diagnostic Imaging, University of Nottingham
  • Diplomate, European College in Veterinary Diagnostic Imaging
  • European Specialist in Veterinary Diagnostic Imaging

I graduated from Cambridge Veterinary School in 2001. During five years in a busy small animal practice, I developed an interest in radiology and ultrasound, and gained the RCVS Certificate in Veterinary Diagnostic Imaging.

I returned to Cambridge in 2006 to undertake a Residency program in Diagnostic Imaging, and I gained the European Diploma in Veterinary Diagnostic Imaging in 2009. I am a European Specialist in Veterinary Diagnostic Imaging.

I am interested in all aspects of imaging, and enjoy using the excellent imaging facilities to progress the interesting and challenging caseload at Dick White Referrals.

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Dick White Referrals - Inma Ferrandis

Inma Ferrandis: Radiologist

DVM CertVDI MRCVS

I graduated in 2002 in Valencia, Spain. After four years working in general practice I moved to the UK due to my growing interest in improving my skills in diagnostic imaging. I finished my residency at Dick White Referrals in 2010 and now I am preparing for the last part of the European Diploma in Diagnostic Imaging in order to become a European Specialist recognised in this interesting field of veterinary medicine.

When I am not at work, I enjoy dancing and going to the cinema.

Dick White Referrals - Roberto Tapia Nieto

Roberto Tapia Nieto: ECVDI Resident in Veterinary Diagnostic Imaging

DVM MRCVS

  • European College of Veterinary Diagnostic Imaging (ECVDI)- approved Resident in specialist training.

I graduated in 2004 as a veterinary surgeon from Caceres Veterinary School in Spain. After an externship in companion animals at the veterinary school of Maisons Alfort in France, I worked in general private practices around Paris for a few years. During this period I developed a passion for diagnostic imaging.

In 2008, I moved to The Netherlands with the aim to explore this subject in greater depth and I spent one year in a referral practice following H. Garretsen (specialist in radiology).

In 2009 I did an internship in diagnostic imaging at the University of Utrecht, under the supervision of Professors Voorhout and E. Auriemma (ECVDI). The experience gained during this time equipped me to join the Diagnostic Imaging team at Dick White Referrals in November 2010 to undertake a Residency in Diagnostic Imaging.

Outside work, I love visiting my family and friends. I also enjoy cycling, climbing, travelling around the world and all kinds of outdoor activities.

Dick White Referrals - Sue Bravo Rodriguez

Sue Bravo Rodriguez: MRI Radiographer

DCR D

I joined Dick White Referrals in September 2007, having qualified as a Diagnostic Radiographer in 1987. I worked for the NHS for 20 years. In that time I became a specialist in CT scanning and then ultimately concentrated on MRI.

I have a keen interest in Neurology, having worked at The Royal London Hospital and specialised as a Neuro Radiographer at King's College and The Maudesly Psychiatric Hospitals in London.

I love the challenge of my new career as a veterinary radiographer and adore working with animals. I find it very rewarding. I have two dogs, Phoebe and Oscar.

Dick White Referrals - Tammy Robinson

Tammy Robinson: Nurse Radiographer

RVN

I joined Dick White Referrals on the day the practice opened in July 2003. I qualified as a veterinary nurse in 1992 and have previously worked in general practice and for an animal charity.

Imaging has always been an interest of mine, and I was more than delighted to join the Imaging team in January 2010.

Outside work, I enjoy family life, socialising and cooking

Dick White Referrals - Jemma Johnson

Jemma Johnson: Nurse Coordinator

RVN

I qualified as a veterinary nurse in 2002.  After working as a neurology nurse at a referral practice, I joined DWR in 2007 where I worked initially as a ward nurse, caring for neurology, orthopaedic and rehabilitation patients.

In 2010 I qualified as a veterinary physiotherapist with the NAVP. Recently, I joined the diagnostic imaging team. Outside work, I enjoy equine sports and country pursuits.

I am married with two lovely little girls, and I have a menagerie of pets.

Treatments - Diagnostic Imaging

Computed radiography

We have a fully equipped digital x-ray suite combining a high frequency Celtic SMR x-ray machine with a floating tilt table and a fully digital AGFA computed radiography processing system. This combination allows rapid and reliable high quality radiography.

The radiographs and all other imaging modalities are stored on our fully integrated PACS (picture archiving and communication system).

This allows us to take X-rays but, unlike in conventional radiography, there is no film - just like a digital camera. This system helps to keep radiation doses to patients to the absolute minimum. The images are sent to high resolution monitors and they can then be transmitted to viewing stations throughout the hospital. Radiographs allow us to perform assessment of the heart and lungs, internal organs, bone abnormalities and by using contrast liquids (radiographic 'dyes' which show up starkly on radiographs) we can create images which highlight certain structures such as the urinary tract, which would not otherwise be detected clearly. Often radiography and ultrasound are used together because each gives different information about similar structures and it is often the combination that is helpful to us.

Treatments - Diagnostic Imaging

Diagnostic ultrasound

Ultrasound is a safe and painless procedure which allows sound waves to be reflected by internal structures, creating "echoes" that are converted into images. This technique is used to visualise muscles, tendons, eyes, the heart, blood vessels and many internal abdominal or thoracic organs. Ultrasound can also allow us to safely guide small sampling needles into structures affected by disease to take small samples (cytology) by sucking cells out through the needle. We have an internationally-renowned Specialist (Butty Villiers) on site to interpret such samples.

We have 2 purpose built rooms dedicated to ultrasound imaging, containing top of the range ultrasound machines. Our newest acquisition is the cutting edge Phillips IU22 machine, which has a flat LCD screen and a wide range of probes including curvilinear probes for general abdomen imaging, a 5-17mHz linear probe to give excellent near field imaging for example for examining tendons and the anterior chamber of the eye, phased array for cardiac imaging and a 3-D probe. This machine allows real time side by side imaging for contrast ultrasound, an additional tool for locating and characterising neoplastic lesions. It has capability for panoramic, 3-D and 4-D image acquisition.

Both the IU22 and the Phillips HDI5000 are fully equipped with harmonic imaging, and allow M-mode, power and colour Doppler, pulsed wave and continuous Doppler for the full range of vascular and cardiac applications. Additionally we have a small but powerful Siemens Accuson Cypress portable ultrasound unit for rapid diagnosis and imaging-guided treatments in emergency patients undergoing stabilisation.

Treatments - Diagnostic Imaging

Magnetic Resonance Imaging (MRI)

This produces very high quality images without the use of radiation. Instead, powerful magnetic field forces produce signals which provide the information from which 3-D images can be constructed. MRI scans are particularly useful in the diagnosis of cancer as well as neurological and orthopaedic conditions. We have a state-of-the-art Hitachi Aperto 0.4T Open Magnetic Resonance Scanner housed within a purpose-built building that includes en-suite anaesthetic facilities. The open magnet allows even the largest of our patients to fit comfortably within the scanner, using a motorised bed for ease of positioning. All patients are anaesthetised to keep them motionless during image acquisition, and this can be monitored by our anesthetists using a full array of MRI compatible monitoring equipment.

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Fluoroscopy

This technique uses X-rays, an image intensifier and a television camera to record 'video clips' of internal organs in motion. Sometimes, contrast substances such as barium sulphate are also used to increase contrast and visibility of specific organs. For example swallowing function can be assessed by imaging an animal which has eaten a meal mixed with barium. Iodine compounds can be injected into the vein, and used to image the passage of blood in some cardiac and liver conditions, and to image the kidneys and bladder as they pass this substance out of the body. We have recently upgraded the fluoroscopy facilities to a powerful Philips BV Endura system to refelect our growing expertise in the field of Interventional Radiology. This unit allows our Interventional Radiology team to obtain clear images of the blood vessels which may be used as a 'route' to the site of pathological problems accessed by only a catheter in a peripheral blood vessel. Digital Subtraction Angiography (DSA) and 'Road-Mapping' techniques allow suppression of any images other than the blood vessels allowing clear assessment in cases of portosystemic shunts, other vascular and cardiac interventional procedures.

Treatments - Diagnostic Imaging

Computed Tomography (CT)

CT allows production, using x-rays, of a 3 dimensional 'volume' images of soft tissues, bones, blood vessels and other tissues. It is particularly useful in assessing joint disease, nasal disease and in planning vascular interventional procedures. Currently, our CT is performed off-site in a local Equine Hospital in Newmarket until our on-site CT is commissioned at the completion of our Phase III hospital expansion.

Treatments - Diagnostic Imaging

Scintigraphy

Occasionally Nuclear Scintigraphy is used in the diagnosis of obscure lameness, in specific diagnosis of some thyroid disorders in dogs and cats, and in assessment of kidney function. Nuclear Scibtigraphy uses very tiny doses of radio-pharmaceuticals which can be detected using a special camera as they emit very small (and safe) doses of radiation. Nuclear Scintigraphy is performed off-site at either Rossdales Equine Hospital or at the Animal Health Trust.