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Phlebotomy

What is an X-Ray?
An x-ray is a common and non-invasive imaging test using electromagnetic radiation to view the inside of your body and to diagnose and treat many medical conditions. X-rays can be used to detect conditions such as fractures, osteoporosis, bone tumors, arthritis, dental decay, infections, lung infections, breast cancer, blocked blood vessels and digestive tract issues. 

What happens before an X-Ray?
You will be required to change into a hospital gown before the procedure.

You will also be asked if you have any metal in your body, which may be in the form of artificial joints, pacemakers, implants or stents. 

In some cases, a contrast material may have to be ingested to improve the quality of the images. You will be required to fast before an x-ray to examine the gastrointestinal tract.

 

What happens during an X-Ray?
An x-ray is performed in our Diagnostic Imaging department and is a painless and non-invasive procedure.

You will stand in front of a specialised plate that contains x-ray film and will asked to position your body to create clear images. X-rays are usually obtained while you are in a standing position. 

In some cases, you may be asked to lie or sit on a specialised plate while a large camera connected to a steel arm moves over your body to capture x-ray images.

It’s important to stay still while the images are being taken to provide the clearest images possible.


What happens after an X-Ray?
You will be able to leave the hospital immediately after the procedure and will be given a follow up appointment to review your test results. Should you feel unwell, contact your doctor immediately  or call our 24-HR Emergency Clinic.

X-ray

How is Osteoarthritis treated?
Osteoarthritis is the most common forms of arthritis and is a degenerative joint disease that affects the cartilage in the joints. 

There is no cure for osteoarthritis, but the condition can be managed to help relieve the symptoms.


Exercise
Exercise is an important treatment for people with osteoarthritis as  regular exercise keeps you active, builds up muscle and strengthens the joints.  Exercise is also good for losing weight, improving your posture and relieving stress, all of which will ease symptoms.

Osteoarthritis Treatment

What is Chemical Chemistry?
Chemical chemistry is concerned with the analysis of liquids originating from inside the body including blood, saliva, mucus and other body tissues that are involved in the transmission of human disease. 

Our laboratory strives to produce test results for a wide spectrum of diagnoses.

What Chemical Chemistry tests are available?
Among the tests we conduct are:

Routine Biochemistries
- Anaemia
- Blood
- Bone Status
- Cardiac
- Gases
- Lipids
- Liver
- Renal
- Urine chemistries
 
Therapeutic Drug Monitoring (TDM)
 
Endocrinology
- Diabetes 
- Thyroid
 - Reproductive hormones
 
Tumour Markers
 
Infectious Serology​ ​​

Clinical Chemistry

What is Magnetic Resonance Imaging (MRI)?
MRI, or Magnetic Resonance Imaging, is a painless and non-invasive procedure where a magnetic field and radio waves are used to view objects in the body. Radio waves are transmitted to a receiver in the machine which forms an image of the body that can be used to diagnose various health issues.

Common areas that are diagnosed with MRI include the brain, breasts, joints, heart and blood vessels.


What is happens before an Magnetic Resonance Imaging (MRI)?
You will be required to change into a hospital gown before the procedure.

You will also be asked if you have any metal in your body, which may be in the form of artificial joints, pacemaker, implants or stents. 


What is happens during an Magnetic Resonance Imaging (MRI)?
You will be made to lie on a table that slides into the MRI machine. You will be given earplugs to wear and to protect your ears as there will be loud repetitive noises during the procedure. Once within the machine, you will be required to keep as still as possible to allow the machine to obtain clear images. Sedation can be administered if you experience claustrophobia.

Images of the area will be taken while you are in the machine, and you will be able to communicate with the technician throughout the test.


What is happens after an Magnetic Resonance Imaging (MRI)?
You will be able to leave the hospital immediately after the procedure. You will  rest in a recovery room if you were sedated prior to the procedure until wake and feel well enough to leave.

You will be given a follow up appointment to review your test results. Should you feel unwell, contact your doctor immediately  or call our 24-HR Emergency Clinic.

Magnetic Resonance Imaging

Iodine 131 Therapy

What is a Biopsy Test?
A biopsy is a diagnostic procedure that involves obtaining a sample of tissue or cells for analysis to diagnose a medical condition. It is definitive way to diagnosis most cancers and is often a follow up procedure after imaging tests detect suspicious lumps and tumours. There are several types of biopsies performed to test if abnormalities in your body are caused by cancer or by other conditions. 
 

What Biopsy Tests are available?
A biopsy is often performed using a needle, a probe or a scope, depending on the area the sample is taken from.  

Bone Marrow Biopsy
A bone marrow biopsy is done if an abnormality is detected in your blood. Blood cells are produced within the bone called the marrow. Analyis of a bone marrow sample may diagnose blood disorders such as leukemia, lymphoma and multiple myeloma.

A long needle is used to draw a sample of bone marrow out of the  hipbone or other bones in your body. You will receive a local anesthesia before a bone marrow biopsy in order to minimise discomfort during the procedure.


Endoscopic Biopsy
This biopsy is done to gather samples from internal organs like the lung, bladder and colon. A flexible thin tube called an endoscope with a light and camera is inserted through a small incision in your body and tools are used to obtain samples. The endoscope can be inserted via the mouth, rectum or urethra. 


Needle Biopsy
This biopsy is done to gather samples and tissue from the skin. It is often done to diagnose tumours under the skin, such as suspicious breast lumps and enlarged lymph nodes. An image-guided biopsy such as a CT scan is often used during a needle biopsy to collect cells from a suspicious area in the organs like the liver and lungs. Other forms of needle biopsies extract tissue, fluid as well as cells.


Skin Biopsy
This biopsy is done when a skin disorder is present, a local anesthsia is applied before a small area on the skin is removed with a blade or scalpel to check for infection or cancer. 


Surgical Biopsy
This biopsy is done when the area to be tested is not possible to reach by other methods, of if other biopsy results are inconclusive. Procedures can be used to remove part of an abnormal area of cells or an entire area of abnormal cells, such as tumours in the breast and abdomen.

Samples are sent to the laboratory for testing to detect the presence of cancer, and if detected, the grading and staging of the cancer will be done to determine the treatment options.. 

You will be given a follow up appointment to review your test results. Should you feel unwell, contact your doctor immediately or call our 24-HR Emergency Clinic.

Biopsy

What is F18 FDG Brain Scan?
A Positron Emission Tomography (PET) scan is a diagnostic imaging procedure used to determine how organs and tissues inside the body are functioning. It allows the detection of certain diseases even before patients display symptoms, allowing for disease development to be determined much more accurately than with other diagnostic imaging techniques.

The F18 FDG Brain Scan is a PET scan that examines the structure and functionality of the brain and its tissues. It can detect the onset of neurological disorders such as dementia (which includes Alzheimer’s disease), and other neurodegenerative disorders.


What happens before a F18 FDG Brain Scan?
Fast for at least 4-6 hours before the scan
Refrain from taking caffeine, alcohol and smoking 24 hours before the scan
Stay hydrated with plain water
Follow a high protein and low carbohydrate diet 24 hours prior to the scan for normal distribution of the radioactive glucose (F18-FDG) in your body
Stop taking sedatives and anesthetic drugs if your doctor advises so
Intravenous fluids containing dextrose or parenteral feedings should be withheld for four to six hours
Inform your physician of any possible allergies to contrast material
Inform your physician if you have a renal disease and is on Metformin (medication)
If you have a fear of enclosed spaces, inform your physician. Medicine or sedatives to help you relax during the procedure may be prescribed.

What happens during a F18 FDG Brain Scan?
The scan will take about 2-3 hours to complete. As the radiotracer used in the scan decays very quickly through a natural process, it is important that you arrive punctually for the scan to be conducted timely.
When you arrive at the Nuclear Medicine Suite, you will be asked about your medical history with your blood glucose level checked before receiving a small amount of radiotracer.
You will be expected to stay in the procedure room for 30 before the nuclear medicine technologist conducts the scan, which will take about 10 minutes.
 

What happens after a F18 FDG Brain Scan?
After the scan, you should experience little to no side effects.
As the PET radiotracer decays quickly, it will also be excreted quickly through your urine.
To expedite the process, you are encouraged to drink plenty of fluids. For precaution, avoid close contact with children and pregnant ladies for at least eight hours.

F18 FDG Brain Scan

How is Breast Cancer treated?
Breast cancer is the number one cancer among Singaporean women. It usually occurs when harmful (malignant) cells originate from the cells lining the milk ducts and glands. In advanced breast cancer, cancerous cells can spread through the breast to the rest of the body.

Breast surgery is part and parcel of cancer treatment and would be required at some point in time to remove cancer cells. Depending on the breast cancer stage, chemotherapy or radiation therapy would also be introduced alongside hormone therapy.

There are 2 main types of breast cancer surgery.
 

Breast-conserving surgery
Breast-conserving surgery could be a lumpectomy or wide local excision, where the tumor and a section of surrounding breast tissue is removed. It could also be a partial mastectomy, where part of the breast is removed.

In breast-conserving surgery, the amount of breast tissue that is removed will depend on the type of cancer, tumor size and its location in breast as well as the size of the breast.

An area of healthy breast tissue around the tumor will always be removed and tested for cancer via a biopsy The chances of the cancer returning is reduced when the healthy tissue does not show signs of cancer. More tissue may need to be removed from the breast if cancer cells are found in the surrounding tissue.

Radiation therapy usually follows after breast-conserving surgery to destroy any remaining cancer cells that may still be present. However, the sequence may also vary.


Mastectomy
A mastectomy is the removal of all the breast tissue to treat or prevent breast cancer. A sentinel lymph node biopsy is removed along with the breast if there are no obvious signs that the cancer has spread or metastasized. The sentinel lymph nodes are the first lymph nodes that the cancer cells reach if they spread and are a part of the lymph nodes under the arms. Lymph nodes will be removed if there are signs of cancer.


Breast Reconstruction
Breast reconstruction is surgery done to create a new breast shape to replace the breast that is removed. It is done after a mastectomy.  A breast implant may be used or tissue from another part of your body can be used to create a new breast.


Lymph Node Surgery
A biopsy may be done on the sentinel lymph nodes to check if cancer has spread to them. The sentinel lymph nodes are the first lymph nodes that cancer cells reach if they spread and are a part of the lymph nodes under your arms. They are also called axillary lymph nodes.

The sentinel lymph nodes are examined for cancer cells and further surgery would be needed to remove here if cancer cells are found.

Hormone Therapy
Hormone therapy lowers the levels of oestrogen or progesterone hormones in your body and helps to shrink a tumour and make it easier to remove. Hormone therapy may be used as the only treatment for breast cancer if your general health prevents you having surgery. It is received for 5 years or more after surgery.

Breast Cancer Treatment

What is Lutetium-177 Prostate Specific Membrane Antigen Therapy?
Lutetium-177 (Lu-177) Prostate Specific Membrane Antigen (PSMA) Therapy is a targeted Nuclear Medicine radionuclide therapy for patients with advanced prostate cancer.


What is the purpose of Lutetium-177 Prostate Specific Membrane Antigen Therapy?
Lu-177 PSMA Therapy allows for very specific and targeted radiation on prostate cancer cells, which is usually radiosensitive. It is often used for metastatic Castrate Resistant Prostate Cancer. The therapy aims to shrink the tumor and stabilize the disease.

Patients whose bodies have not been responsive to other therapies or treatments may be referred to undergo this therapy.

What happens before Lutetium-177 Prostate Specific Membrane Antigen Therapy?
Fasting is not required but water is permissible as you will need to stay hydrated
Medications may need to be on hold until the therapy is completed. Consult your doctor or Nuclear Medicine Physician to check for detailed instructions
Before the actual treatment, you will  need to undergo a consultation session with a Nuclear Medicine Physician, a PET/CT PSMA scan, and some blood tests at different intervals

What happens during Lutetium-177 Prostate Specific Membrane Antigen Therapy?
A cannula (a small plastic tube) will be placed into your vein
You will be given anti-nausea medication
You will receive intravenous hydration (normal saline). The administration of Lu-177 PSMA Therapy will commence about 60 minutes after administration of the normal saline
The Lu-177 PSMA Therapy procedure will take place for about 30 minutes
A Nuclear Medicine Technologist will monitor the level of radiation from you after the infusion procedure is completed at different intervals
Each Lu-177 PSMA Therapy cycle involves an outpatient appointment at Nuclear Medicine Suite. You may be required to remain in the suite for an estimated 6-8 hours throughout the therapy session
You will be scheduled to return the next day, at approximately 24 hours post-infusion, for a full body scan
 
What happens after Lutetium-177 Prostate Specific Membrane Antigen Therapy?
There are potential risks and side effects in undergoing this treatment. Short term  complications following administration of Lu-177 include nausea and headache
Vomiting may also occur on rare occasions. Pre-medications are given to reduce the likelihood of these side effects
You are encouraged to be on oral rehydration for at least two days after the procedure to keep your body hydrated
After the procedure, the radiotracer will quickly decay and will be excreted through your urine
Flush the toilet twice after each use. Avoid splashing while urinating to prevent contamination
Normal activities can be resumed after the post-infusion full body scan
Avoid prolonged close contact (at least six feet distance) with pregnant women and young children under the age of five, for at least one week after treatment

Lutetium-177 PSMA Therapy

Anal Fissure Treatment

Diabetes Mellitus Treatment

Amyloid PET Brain

What is an Eye Examination?
An eye examation is a range of tests performed to assess eye health and function. These range from reading a standard eye chart, to more detailed tests using machines to examine the internal structure of the eye.

Regular eye exams are very important to ensure the health and overall wellness of your eyes. They can be performed to determine the prescription for glasses or contact lenses for long and short-sightedness. They also help detect common and chronic eye diseases and determine early signs of eye disease. which help in assesment of treatment methods.  

Certain cases require a eye exam done urgently. Red and itchy eyes or when vision is affected by flashes and floaters could be indicative of eye disease. You should get an eye examination done if you experience difficulties with your vision, have recurrent headaches, or have recently experienced head trauma.

You require more eye exams if you have a family history of conditions like glaucoma or diabetes, as they may detect conditions such as age-related macular degeneration (AMD) and cataracts.

 

What happens before an Eye Examination?
You will be asked about your medical history or any symptoms of vision problems experienced.

What happens during an Eye Examination?
Several tests are done to evaluate a range of eye problems and disorders. You may be asked to read letters of different sizes to test for long or short-sightedness, or colours printed on a chart to check for vision clarity. Colour defiency can also be detected through this test to see if you are colour blind.

Your inner eye structure and the back of your eye may be examined for damaged cells. Fluorescein drops are administered to detect foreign bodies or injuries to the cornea in the eye. The cornea is a clear surface that covers your outer eye. A dye or fluorescein is applied to the surface of the eye and spreads over the eye from blinking motions. A cobalt-blue light is directed onto your eye through a tool called a slit-lamp or ophthalmoscope. Abnormalities, abrasions or damage to the cornea can be detected through this procedure.

A retinal examination assesses the back structures of the eye, including the retina, to check for possible eye disease.

Your eye pressure may be measured to detect glaucoma, a condition where your optic nerves are damaged. The test is done with a machine or through a slit-lamp tonometer.

Your corneal thickness may be assesed when you eye pressure is higher than normal. An instrument that uses sound waves is used.to measure cornea thickness. An anaesthetic eye drop is administered to the eye to dilate them when measuring eye pressure.
 


What happens after an Eye Examination?
You will be given a follow up appointment to review your test results. Should you experience vision difficulties or red or itchy eyes, contact your doctor immediately or call our 24-HR Emergency Clinic.

Eye Examination

Histopathology is the study and examination of tissue under a microscope to detect and diagnose disease.This can come in the form of a biopsy to detect cancer or benign tissue growth, or the study of changes in cells that may indicate disease. 

Histopathology

What is a Tonometry Test?
A tonometry test estimates the pressure inside your eye, known as intraocular pressure (IOP), to check for glaucoma.

The disease is caused by the slow drainage of the fluid that normally bathes and nourishes the eye; causing a pressure build-up. If untreated, the pressure may damage the optic nerve causing blindness. As these eye changes are often painless and have no symptoms, they can persist for years undetected. Most health screening centers used air-puff tonometry to measure.

What happens during a Tonometry Test?
It does not touch your eye but uses a puff of air to flatten your cornea. The patient is seated with the chin resting on the device. The operator activates the air puff mechanism while aligning the focus to the patient’s eye through the tonometer monitor.

Air puff tonometer is a preliminary way to measure IOP. If high pressure is detected using this method, it is advisable to consult a specialist to check further.

Tonometry Test

What is Computer Tomography (CT) Scan?
A computed tomography or CT scan is a non-invasive and painless test that is conducted to obtain a precise image inside the body. Using a technology that gives more detailed images than a standard x-ray can, images produced by a CT scan includes the bones, organs and muscles that help in making accurate diagnoses. CT scans are normally requested as a more detailed procedure after a standard x-ray is performed.
 

What happens before a Computer Tomography (CT) Scan?
You will be required to fast for 2-4 hours before the test. This is important to ensure accuracy because food ingested before a test can impact the quality of the images.

You will be required to change into a hospital gown before the procedure.


What happens during a Computer Tomography (CT) Scan?
You will be asked to lie down on a table attached to a CT scanner with the portion of your body to be examined exposed. The scanner then takes x-ray images of the area, rotating and tilting to scan from different angles and positions. The images are then sent for analysis to aid in diagnosis.

The scan lasts a few seconds and you will be required to lie very still during the scan to obtain the clearest and most images possible.

In some scans, a dye-based contrast material is injected into a vein to enhance images and make it easier for diagnosis. It helps with the checking for abnormal growths and tumours, inflammation, and nerve damage.

 

What happens after a Computer Tomography (CT) Scan?
You will be given a follow up appointment to review your test results. Should you feel unwell, contact your doctor immediately or call our 24HR Emergency Clinic.

CT Scan

What is an Anoscopy?
An anoscopy is a simple procedure that can help identify several conditions and diseases that can affect the lower part of your intestines. These include cancer, tears in the tissue or anal fissures, swollen veins around the anus and rectum called hemorrhoids, and rectal polyps.

What happens before an Anoscopy?
You will be given a laxative or enema to take before the procedure to help you completely empty your bowels.

You will be required to change into a hospital gown for the procedure.


What happens during an Anoscopy?
Your doctor may request that you position yourself in the fetal position on a table, or bend forward over the table. 

He then inserts an anoscope, a rigid hollow tube with a light, into your rectum and anus to examine them in detail.

You may be asked you to clench and relax your internal muscles as you would when having a bowel movement. This helps with the placement of the anoscope during the procedure.

What happens after an Anoscopy?
You will be given a follow up appointment to review your test results. Should you feel unwell or experience abdominal pain or bleeding, contact your doctor immediately or call our 24-HR Emergency Clinic.


Anoscopy

Whats is a Digital Rectal Examination (DRE)?
Digital rectal examination (DRE) is a simple procedure conducted by doctors to check for an enlarged prostate. It is done through the insertion of a lubricated gloved finger into the rectum, a quick and easy way to detect an enlarged prostate. It can detect conditions like Benign Prostate Hyperplasia (BPH) and prostate cancer.


What happens before a Digital Rectal Examination (DRE)?
No preparation is needed for the procedure. You will be asked to remove your clothes below the waist and will be given a gown to change into.


 

What happens during a Digital Rectal Examination (DRE)?
You will lie on the examining bed on your left with your buttocks near the edge of the examining bed with both knees up and brought close to your chest. Your doctor will gently insert a gloved, lubricated finger into your rectum to feel for any abnormalities or hard lumps. You may feel temporary discomfort and pain, or the urge to urinate during the examination.

What happens after a Digital Rectal Examination (DRE)?
You will be able to leave the hospital immediately after the examination. A follow-up appointment will be given if further tests are needed based on abnormalities present during the examination. Should you feel unwell or experience pain or bleeding, contact your doctor immediately or call our 24-HR Emergency Clinic.

Digital Rectal Examination

What is a Colonoscopy?
Colonoscopy is a procedure that examines the inside of the colon and rectum to investigate gastrointestinal problems such as abdominal pain and bloating. A long, thin, flexible tube called a colonoscope is inserted into the rectum and guided into the colon to check for polyps and tumors.
 

What happens before a Colonoscopy?
You will need to fast for at least 6 hours to ensure that your stomach is empty. Inform your doctor of underlying chronic conditions you may have, such as diabetes, heart disease or high blood pressure and if you are on regular medications. You may be instructed to stop taking certain medications a few days before the procedure, such as blood thinning medications that may increase your risk of bleeding. 

You will be required to do a bowel preparation before the procedure and will be given a solution to consume the day before the procedure. The solution will cause diarrhea to ensure that the colon is free from fecal matter before the colonoscopy is done. You will also be restricted to a soft or liquid diet and may only consume clear liquids like soups, water and juice.
 

What happens during a Colonoscopy?
Your breathing, heart rate and blood pressure will be monitored throughout the procedure.

Your doctor will insert the colonoscope into your anus. A tiny camera attached to the scope will transmit images to a video monitor. This enables the doctor to look for abnormalities in your lower digestive tract. Tissue samples will be collected for analysis and polyps will be removed if they are present.

 

What happens after a Colonoscopy?
You will rest in a recovery room after your colonoscopy and your vital signs will be closely monitored until the sedation wears off.

You will be allowed to leave the hospital once you are well enough. You will be given a follow up appointment to review your test results.

Should you feel unwell after the procedure, contact your doctor immediately or call our 24-HR Emergency Clinic.

Learn more about AI-assisted colonoscopy to improve colorectal cancer screening here.

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