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Who
Needs a Full Body Scan? (January 2002)
Preventive Imaging Leader Says Procedure Not for Everyone
Denver-Dr. James Ehrlich, Medical Director of Colorado Heart and Body Imaging, a world-class, comprehensive preventive screening center for the early detection of heart disease and cancer, says that the body scan procedure is controversial because its roles and limitations are widely misunderstood by the public, the physician community and the lay press.
Recent national media attention (Oprah, Wall Street Journal, USA Today, etc.) has created a huge demand for the heart scan, lung screen and abdominal/pelvic CT images, which comprise the basic elements of a body scan. "The concept that a totally noninvasive imaging procedure may provide a 'fantastic voyage' through the body is enormously appealing," says Ehrlich. "And it will undoubtedly save a few lives. However, its value is oversold in some regions of the country and it is certainly not a substitute for a complete examination by a doctor."
An FDA-approved coronary artery scan (heart scan) and an accurate coronary calcium score (demonstrating plaque or "atherosclerosis") comprise most of the true value of the body scan. "The significance of the coronary score is vastly under-appreciated and misunderstood by most physicians and many cardiologists," notes Ehrlich, who is currently editing a textbook on contemporary screening practices. "The statement by some doctors as published in the lay press that the test has 'lots of false positives' is an absolute giveaway that the doctor does not understand newer concepts in preventive cardiology. The heart scan should only be performed using an advanced CT scanner called Electron Beam Tomography (EBT), which has been extensively validated for the early detection of heart disease."
Ehrlich notes that much of the body scanning being performed today is done with lesser technology, which also exposes patients to increased radiation. "Recently, there has been a proliferation of spiral or helical CT scanners performing body scans and coronary exams," he says. "What is not generally appreciated is the fact that spiral scanners expose individuals to much higher radiation doses than EBT, and spiral or helical CT scanners have never truly been validated for the most valuable component of the procedure - cardiac imaging. We want people to invest wisely in their health and therefore, we recommend the lower radiation, gold-standard EBT scanner manufactured by Imatron, now a subsidiary of General Electric."
Ehrlich, who also directs centers in Houston and Washington DC, says however, that there is a definitive segment of the population who can and will benefit from a full-body EBT scan. "The ideal candidates are intelligent, proactive middle-aged consumers who realize that the test is merely an opportunity to find unexpected disease years or decades before dangerous symptoms develop," he says. "The abdominal and lung portions of the procedure will sometimes reveal innocent nodules of no medical significance that could lead to further testing. A normal test can occasionally be falsely reassuring as a non-contrast imaging screen cannot see all abnormalities in the body."
"We think the coronary scan by EBT could easily be considered the most valuable five minutes one could spend in any city," he adds. "Most heart attacks and sudden deaths occur in people who have an unremarkable cholesterol level and a normal treadmill test, yet a relatively high 'calcium score' by EBT in the weeks preceding the catastrophic event. The simple EBT scan frequently leads to lifelong proven strategies to decrease risk for the nation's number one killer. In Denver alone, over 600 physicians have undergone the procedure. Approximately one-third of them are now on new lifelong medications after our five-minute procedure-now that's impact!"
When it comes to insurance, Ehrlich hopes the majority of managed care companies will eventually react intelligently to the growing consumer interest in meaningful preventive imaging procedures.
"We believe that early detection often made possible by sophisticated radiologic imaging is a key to successful preventive strategies."
About Colorado Heart and
Body Imaging-
In addition to the early detection imaging services of EBT scans, CHBI
provides easy access to information about risk-lowering strategies, medications,
products and lifestyle choices. The center offers lung, heart, colon,
total body and bone density imaging for early detection of coronary disease
and cancer as well as non-imaging based services and consultation. CHBI
uses FDA-approved electron beam tomography (EBT), with its extraordinarily
fast acquisition speeds. CHBI is associated with Colorado Imaging Associates,
P.C., a group of board certified radiologists serving the Denver area
since 1957. For more information, contact Colorado Heart and Body Imaging
at 303.433.8800.