Diagnostics of Cancer

The LISOD advisory services are provided by oncologists from Israel with years of experience working in renowned clinics such as Rambam Health Care Campus, Hadassah Medical Center, and Ichilov Hospital. Our patients who have female genital diseases are consulted by the head physician of the clinic, an oncogynecologist, a professor and a medical doctor.

The patients, who have various oncological problems, are treated by the top professionals, no matter what tumours they have in any part of their body, whether they need additional examination and treatment, or if they need to confirm or disprove the diagnosis established in a different medical institution.

Our specialists lead examinations, analyze documents, and appoint a diagnostic routine in accordance with international standards. After the diagnostics procedure, results are known to the council of our physicians, and they develop an optimal treatment plan. When the patient visits the oncologist for the second time, he or she receives a conclusive decision as well as a prepared treatment plan.

The LISOD Hospital operates its own PET-CT. According to the examination results, radiologists locate the tumour and define it as benign or malignant. These professionals can establish the difference between new formations and an inflammation process. If it is cancer they can also define the lesion site.

The application of positron emission tomography allows to define cancer in its “zero” stage, when there are still no essential changes in tissues. The CT locates pathogenic cells precisely. We usually hold several examinations instead of one. The oncologists from Israel work out the treatment tactics and make particular appointments concerning specific characteristics of the patient’s tumour. In most cases the application of positron emission tomography (PET) excludes any further analyses taken. Besides, PET-CT is used to evaluate the effectiveness of a treatment as well as to plan radiation therapy in a better way.

The PET-CT examination procedure of patients by the LISOD Hospital personnel is full-fledged diagnostics with double-proofed analysis of the results by the nuclear medicine specialist and radiology professionals from Israel.

The LISOD Hospital widely uses endoscopic ultrasonography or simply ultrasound (EUS) to diagnose the diseases of the digestive system.

The endoscopic ultrasonography is applied while diagnosing these conditions:

• colorectal cancer, duodenal cancer, stomach cancer, oesophageal cancer;
• submucosal masses in the stomach, oesaphagus and colon (lipoma, fibroma, leiomyoma);
• ulcers in the stomach, oesaphagus, colon, and duodenum;
• esophageal varicose vein dilatation;
• biliary diseases.

The EUS is used to diagnose and take tissue samples from the new formations which were practically inaccessible for minimally invasive methods earlier such as tumours and lymph nodes of the mediastinum, and transverse fissure of the liver, pancreas, and small pelvis.

The EUS allows defining of the cancer lesion site scope (if it includes lymph nodes and other organs) and performing a biopsy to diagnose the examined organs condition. This way, the disease stage is established and the most effective treatment plan developed.

An EUS is totally painless. We apply minimal anesthesia so the patient falls asleep and feels nothing. They then wake up easily and have no side effects. At the same time, physicians have a much better chance to examine patient’s condition thoroughly.

Endoscopic Examinations

Very accurate digital video-endoscopic equipment is necessary to conduct over 40 endoscopic procedures in the hospital such as:

• diagnostic esophagogastroduodenoscopy;
• diagnostic cholangiopancreatography;
• medical cholangiopancreatography;
• diagnostic colonoscopy;
• endoscopic hemostasis;
• polypectomy;
• biopsy;
• introduction of an enteric feeding tube;
• removal of foreign bodies;
• diagnostic video rectosigmoidoscopy;
• argon plasma coagulation;
• cleansing enema;
• preparation for a colonoscopy;
• bronchoscope-controlled intubation;
• endoultrasound of rectum;
• endoultrasound-controlled fine-needle biopsy;
• stomach walls endoultrasound;
• esophageal and mediastinal organs endo-ultrasound;
• pancreas and biliary area endo-ultrasound;
• trachea and bronchi stenting;
• esophagogastroduodenoscopy for Barrett’s oesophagus;
• colon endoscopic stenting;
• pyloroduodenal area endoscopic stenting;
• esophagus endoscopic stenting;
• mapping before endoscopic stenting;
• endoscopic excisional biopsy;
• deep endoscopic biopsy;
• endoscopic dilatation of coloanal anastomosis structure;
• endoscopic percutaneous gastrostomy;
• removal of big polyps;
• endoscopic mucosal resection;
• medical oesophagogastroduodenoscopy for angiectasia;
• endoscopic removal of flat polyps;
• endoscopic removal of new formations in larynx;
• diagnostic nasopharyngolaryngoscopy;
• endoscopic drainage of liquid formations;
• medical cholangiopancreatography;
• medical bronchoscopy;
• recanalization;
• endoscopic submucosa dissection;
• atypical papillosphincterotomy, pancreatic ducts stenting;
• esophagogastroduodenoscopy with balloon hydrodilatation of constrictions;
• choledochus stenting with metallic stent;
• diagnostic duodenoscopy;
• diagnostic bronchoscopy;
• suction bronchoscopy;
• diagnostic nasopharyngolaryngoscopy and otolaryngologist consultation.

The polyps which are detected during a colonoscopy are removed to prevent colorectal cancer. The high-quality imagery allows finding even the smallest anomalies. The painlessness and comfort of the procedures are also of the great importance to patients.

The LISOD Hospital utilizes effective system to diagnose benign and malignant tumours of the mammary glands. Ultrasonography or mammography is performed depending on the age of a female.

The hospital professionals carry out all kinds of biopsies for mammary gland tumours such as aspiration biopses (in case of a cytologic examination), stereotactic biopses (in case of a histologic examination), ductographies to examine mammary glands ducts, and Trucut-biopses for histologic examinations.

The main purpose of these procedures is to define if the pathological process is benign or malignant.

The LISOD Hospital is also capable of holding high-technology stereotactic biopses. Special equipment (Lorad MultiCare Platinum complex) allows accurate and painless sampling and sometimes even complete removing of new formations ranging up to 1.5 cm in diameter. A vacuum aspiration procedure on new formations is a good alternative of surgical intervention.

All the operations are anaesthetized and performed without any hospitalization. These procedures do not need any special preparation. The samples provided by a biopsy are processed by the certified labs in Germany and Israel.

The Department of Nuclear Medicine is equipped with a Millennium VG Gamma Camera (General Electric). The scintigraphic methods are used to diagnose diseases and what stage they are at, as well as for early detection of metastasis early and establishing the condition of the body organs before surgery and during the course of chemotherapy. The decision on the application of such kind of diagnostics is taken by a clinical oncologist from Israel.

There is a wide range of applicable examinations: skeletal system scintillation scanning, kidney scintigraphy, lymphoscintigraphy, hepatic scintigraphy, thyroid scintigraphy, parathyroid scintigraphy, oesophagus and stomach scintigraphy, scintigraphy with somatostatin receptor analogues (cases of neuroendocrine and carcinoid tumours), and perfusion lung imaging (scintigraphy).

In our hospital, computer tomography (CT) is used to scan the head and neck, the upper and lower abdomen, the pelvis, joints, the spine, and limbs. There are also means for CT urography, an X-ray examination of the urinary system that evaluates the kidneys excretory function and any deviations in the urinary excretion system and surrounding tissues. A CT scan is used to control all kinds of biopsies performed in soft tissues, liver, bones, lungs, and mediastinal organs.

The Hospital avails of PHILIPS multi-planar computer tomography scanner that is capable of contrast enhancement for better visualization.

Important x-ray diagnostics can be performed in the hospital. They cover examinations of the thoracic cavity, abdomen and pelvis organs, and bones and joints. An x-ray is used to control numerous invasive surgical operations. Bed patients can also be examined through x-ray diagnostics equipment as we have a portable x-ray unit.

The LISOD gynaecological oncology department performs diagnostics and treatment of all the types of female genital diseases, both benign and malignant.

Our leading specialist is a full professor who holds an academic degree of doctor of medicine. The thorough examination includes a colposcopy, vaginal ultrasound, cytological scanning and various types of biopsies. The treatment plans are developed by the council of physicians only after examination results are known.

The LISOD Hospital utilizes the following methods of cervical cancer prevention:

• Cancer precursor disease diagnostics and timely treatment
• Papillomavirus immunization

The LISOD Clinical Lab boasts of:

• top professional staff members;
• all necessary biochemical, hematological, immunological, and microbiological examinations and tests;
• capabilities to detect most of the known oncological markers: S-100 protein, AFP, PSA, PSA Free, CEA, СА-125, CA 15-3, СYFRA 21-1, СА 19-9, NSE, СА 72-4, SCC, and СD 44 std;
• computed and automated procedures: all tests are reliable and take no more than 20-30 minutes from sampling to the result;
• up-to-date equipment: our spectroscopic system allows acquiring results of the highest accuracy.

The Lab uses the most advanced equipment:

• COBAS INTEGRA 400 Plus – a fully automated biochemical analyser;
• COBAS e 411 – a fully automated immunochemical analyser.

Both urgent and routine analyses are made.

Clinical Lab, gallery (3 photos)

The research is performed by the leading pathomorphology labs in Germany, Israel, and Greece. The partner labs receive all the specimens and samples of tissues provided from the biopsies and surgeries. They also receive cytological and histological material. Pathomorphology verification is the basis of proper diagnostics and further treatment.

The LISOD pathomorphology labs carry out additional examinations. Their results are used to run various chemotherapy courses, particularly through the targeted therapy medications.

Up-to-date methods are also applied to carry out molecular and genetic examinations of the patient blood and cancer cells. As a result, cancer susceptibility is established. In oncological cases we also define the level of aggressiveness in malignant tumours and work out optimal treatment plans.

The hospital is capable of holding intraoperative pathomorphology tests and the physicians make decisions on the surgery scope during operations.

Pathomorphology Lab Examinations

• Genetic examination of recurrent mammary gland cancer risk (23-gen analysis) US;
• K-RAS (EL) gene examination;
• comprehensive histological analysis of frozen sections;
• microsatellite instability (MSI) determining;
• histological examination (1-3 objects);
• histological examination (4-9 objects);
• histological examination (over 10 objects);
• immunohistological examination;
• histological samples revision (1-3 objects);
• histological samples revision (4-9 objects);
• histological samples revision (over 10 objects);
• FISH-testing (G);
• PCR-testing (G);
• K-RAS-testing (G);
• EGFR mutation testing;
• BRAF (G);
• PCR with MGMT methylation;
• gene expression analysis of biopsy sample (GR320);
• genetic examination of recurrent mammary gland cancer risk (23-gen analysis-GR400);
• molecular diagnostics and prognosis by means of gene expression definition (GR310);
• lung tumour sample molecular analysis (GR340);
• mammary gland tumour sample molecular analysis (GR350);
• colon tumour sample molecular analysis (GR360);
• glioblastoma tumour sample molecular analysis (GR370);
• KRAS, BRAF, EGFR oncogenes mutation analysis and EGFR, PTEN, ERBB3 (GR990) gene expression analysis;
• tumour gene expression analysis for detection of chemoresistance (GR1000);
• ALK-EML-4 translocation (G);
• FISH-testing (I);
• PCR-testing (I).

The professionals at LISOD also utilize a contemporary method for new skin formations diagnostics called photo-dermatoscopy. This method provides high accuracy of a result and good basis for a treatment plan. All examinations are carried out by an experienced dermatologist.

LISOD's equipment for ultrasound diagnostics has various types of sensors. We perform examinations of the abdomen, small pelvis, kidneys, bladder, mammary and thyroid glands, transvaginal ultrasounds, transrectal ultrasounds, and ultrasound scanning of the neck, testicles, heart, and soft tissues.

The ultrasound is used to control punctures and other manipulations (prostate and thyroid glands punctures, pleurocentesis and laparoscopic paracentesis, nephrostomy etc.)