QUALIFYING FOR TULSA
*PLEASE NOTE* If you do not qualify for TULSA-PRO, you may be eligible for HIFU treatment.
Do you have any of the following:
- Cardiac pacemaker/pacemaker lines
- Automatic Internal Cardiac Defibrillator
- Brain Aneurysm clips
- Cochlear implant (ear surgery)
- Cardiac Surgery in last 6 weeks
- Tissue expander prior to breast implant
***If the patient answered yes to ANY of the above, the patient is ineligible for an MRI procedure at Choice Diagnostic Imaging and the TULSA procedure. ***
IF YOU ANSWERED NO TO THE ABOVE AND HAVE ALREADY HAD A 3T MRI, THEN YOU WILL QUALIFY. YOU WILL STILL NEED TO DISCLOSE ANY OF THE FOLLOWING THAT applies.
Do you have any of the following:
- Surgical Implants – Electrically, Magnetically or Mechanically Activated
If so, where? Do you have an implant card? When was it implanted?
- Continuous Glucose Monitor and/or Insulin Pump
- Penile Implant
- Removable Heating Aids (Must be removed prior to entering MRI Suite)
- Neurostimulator (Tens-Unit)
- Holter Monitor
- Shunts, stents, filter, or valves
- Location:
- Type:
- Metal chips, foreign body or surgical device in eyes
- Occupations with exposure to metal fragments
- Metallic foreign bodies / Shrapnel / If so, Where?
- Metal rods, metal plates, pins, screws, nails or clips
- Aortic, brain, or carotid clips
- Harrington rod
- Prosthesis – Type:
- Surgery date:
- HIP REPLACEMENT Surgery
- Weight/Obesity
***If the patient answered yes to the above, there must be further discussion with the diagnostic group to ensure the ability to have a 3MRI. ***