Exam Preparation

All patients: Please read the general patient information below.


To Our Patient.

  • If you have previous X-rays or scans at another facility of the area we are to study, bring them with you to your appointment.
  • With all exams, take your usual medications with the minimum necessary water, unless instructed otherwise.
  • Leave jewelry and watches at home. Wear loose, comfortable clothing.
  • Let our staff know if you are pregnant or breast feeding.
  • If you do not see your exam listed below, it may be because no special preparation is necessary.
  • Please arrive at our office at least 15 minutes prior to your exam to complete or update any necessary paperwork, unless otherwise directed.


Click on one of these links to jump to your exam:

Important note: Patients taking Glucophage® or Glucovance® (metformin HCl)
DEXA - Bone Density


  • Patients should wear clothing without any metal clips, ties or belts.
  • Because MRI uses a strong magnetic field, please notify us prior to your exam if you have a pacemaker, artificial heart valve or any other metal inside your body. Additionally, any jewelry or body piercings will need to be removed.
  • Abdominal MRI/MRA, nothing to eat or drink 4 hours prior to appointment. You may have plenty of water.

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Important note regarding IV Contrast with Glucophage® or Glucovance® (metformin HCl)

If you are on either of the above medications, please discontinue the drug on the morning of your exam. Instructions and a lab slip for Bun and Creatinine will be given to you. You should refrain from taking these medications for 48 hours, and only resume taking them after your doctor has checked the lab results for normal renal function.
The reason for this directive is: Intravascular contrast studies with iodinated materials (X-ray dye) can lead to acute alteration of renal function and have been associated with lactic acidosis in patients taking Glucophage® or Glucovance®.

Pre-medication for IV Contrast
Clinical Indication:

  • For patients with known allergy to IV Contrast
  • For patients with very high risk of IV Contrast Reaction



  • 40 mg Prednesone the night before the exam
  • 40 mg Prednesone the morning of the exam
  • 50 mg Benedryl the morning of the exam

NOTE: It is recommended that you find somebody else to drive you to the office, since the Benedryl may cause drowsiness.

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CT Exams


Depending on your CT, you may receive contrast material to enhance the images we obtain from your exam. There are two types of contrast material used:

  • IV Contrast (X-Ray Dye)
    This enhances the blood vessels and organs on the images. You should not eat or drink anything for 4 hours prior to the exam. This is to prevent you from aspirating vomitus, should the unlikely event occur.
    If you are taking Glucophage® or Glucovance®, please see the note above.

  • Oral Contrast
    This delineates the bowel more precisely on the images.
    You should pick up the contrast material at our Ponahawai Office or in West Hawaii and drink it as instructed before your exam or for urgent studies plan to be at our office 2 hours prior to your exam to have time to drink the contrast.


Head, IAC, Temporal Bones, Orbits, Neck, Chest, Extremities

  • Do not eat or drink anything for 4 hours prior to the exam unless the exam is ordered specifically stating "without contrast".



Chest, Abdomen, Pelvis, Liver, Pancreas, Spleen (with contrast)

  • Do not eat or drink anything for 4 hours prior to the exam.
  • You need to pick up oral contrast at the Ponahawai clinic on the day before the exam.
  • If the exam is on the same day, you need to arrive 2 hours early to drink the oral preparation.

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Some ultrasound exams require the patient to refrain from eating or drinking for at least 6 hours prior to the exam. This is to prevent the gallbladder from contracting.
Diabetic patients on medication will be scheduled appropriately so they will not become hypoglycemic (low sugar) due to fasting.

Abdomen, Gallbladder, Liver, Spleen

  • Do not eat or drink after 10pm the night before the exam, or at least for 6 hours prior to your appointment.


Pelvis, OB, Amniocentesis

  • Finish drinking 32-48 fl. oz. of liquids by 1 hour prior to the appointment. Liquids may be anything except dairy products.
  • You must have a very full bladder for the exam. Please try not to urinate until after the exam.
  • You may eat normal meals.


Breast Biopsies

  • Either you or a guardian, if needed, must be able to give an informed consent for the procedure.
  • You should have a driver available after the procedure
  • Please contact the WIC scheduler if any of the following is the case:
    • You are taking aspirin or any other blood-thinning medication
    • You are allergic to Lidocaine
    • You need antibiotic therapy before any dental or surgical procedures.


Stereotactic Biopsy


  • You must be able to lie on your stomach for at least one hour, and weigh less than 300 pounds.


Needle Localization

  • No perfumes, powders, or deodorant on the day of the exam
  • Eat a light meal. Do not intake any caffeinated foods (coffee, soda, etc.)
  • Do not take aspirin for at least three days prior to your appointment.
  • Wear comfortable, 2-piece clothing and a comfortable bra.
  • Do not wear earrings or jewelry.
  • Have a driver available after the procedure.

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Esophagus - Barium Swallow

  • Do not eat or drink anything after 10 pm the night before the exam.


Upper Gastrointestinal - UGI, Small Bowel (SBFT)

  • Do not eat or drink anything after 10 pm the night before the exam.
  • Do not take oral medications until after the exam.


Gallbladder - Oral Cholecyctogram (OCG)
This is a 2-day exam:

  • 1st day - A preliminary X-ray is done and the patient is given the oral contrast.
  • 2nd day - X-rays of the gallbladder are performed.


Barium Enema (BE, BE Air Contrast, or Double Contrast BE)

  • A preparation kit will be given to you on the day before the exam. If you don't have a kit, you should pick one up at the Ponahawai Clinic. Instructions are included in the kit.


Intravenous Pyelogram - IVP

  • A preparation kit will be given to you on the day before the exam. If you don't have a kit, you should pick one up at the Ponahawai Clinic. Instructions are included in the kit.

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  • No perfume, deodorant or powder on the chest or underarm area the day of the exam.
  • You will be asked to undress from the waist up. Please wear appropriate apparel.
  • It is best to schedule your mammogram the week after your period when the breast are less tender.
  • Advise the Technologist if you have any particular symptoms or can describe an abnormality. Also, be sure to mention any family history of breast cancer.
  • Bring any prior mammograms with you to your appointment, if possible, for the radiologist to compare.
  • If you have breast implants, let us know when you make your appointment so we can optimize your exam.

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DEXA (Bone Density Exam)

  • The weight limit of the exam table is 350 pounds.
  • You should not have any of the following for at least three days prior to the exam: radiopaque contrast (barium) or radioactive injections (nuclear medicine exam).
  • Do not take calcium supplements or vitamins on the day of the exam.
  • Do not wear clothing that has a button or zipper around the waist.

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Hawaii Radiologic Associates