Is CT scanning for everyone? (Health Care Industry Spotlight).

Consumers are increasingly familiar with the barrage of advertising and hype for Computed Tomography or, 'CT scans.' This newer generation of fast scanners are called Multi Detector CT Scans (MDCT) and are available at a wide number of health care facilities helping medical professionals to identify potential trouble spots within the body like never before. But, does everyone need a MDCT scan? While some patients are finding that the results produced from a scan can be very revealing, doctors say everyone may not benefit.

"Although MDCT scans are advanced technology, and offer some images not possible through other testing, this is not necessarily a reason for consumers to run out and incur any unnecessary medical expenses," says Randy Mound, M.D., radiologist from Encino-Tarzana Regional Medical Center. Encino-Tarzana, which recently installed a Marconi Philips multislice CT scanner recommends patients to come with a recommendation from their physician to obtain a scan.

Unlike conventional x-rays, which produce pictures of the "shadows" cast by body structures of different densities, CT scanning uses x-rays in a much different way. The machine revolves around a patient, emitting and recording x-ray beams from as many as a thousand points on a circle. A special computer program then uses the differences in x-ray absorption to form cross-sectional images or "slices." These slices are called tomograms, hence the name "Computed Tomography."

"CT produces an enhanced view into the body," says Dr. Mound. "However, to capitalize on healthy people's fears that they might have something hidden inside isn't why this technology was implemented. At this point, we do not have any reason to think everyone needs an MDCT."

MDCT has applications that can be helpful in diagnosing a variety of diseases including lung cancer, coronary artery calcification, and diseases of the colon. According to Dr. Mound, here's who may actually benefit from a CT:

Lung cancer patients: According to the American Lung Association, there were 156, 900 deaths in 2000 from lung cancer. According to Dr. Mound, there is evidence that people who are over the age of 50, particularly smokers, might benefit from a CT scan. Often times when lung cancer is found on a traditional x-ray, it is too advanced. A CT may give an earlier warning and therefore allow for better response to treatment.

"Lung cancer remains one of the most difficult cancers to successfully treat and we are continually in need of innovative approaches both in detection and treatment," says Dr. Mound. "Preliminary data from recent studies suggests that low-dose spiral CT screening of high-risk patients increases the detection of early-stage lung cancer which, when detected this early, has a greater than 80 percent anticipated cure rate."

Patients with coronary artery calcifications: MDCT scans are useful for both patients and doctors to estimate the amount of coronary artery disease present and to make decisions about potential cholesterol lowering drugs, further tests and behavior modifications.

People with diseases of the colon: CT is considered a new and developing technique for identifying polyps and cancer inside the colon through CT Colonograpy -- also called Virtual Colonoscopy -- but some doctors say it's not meant to replace a colonoscopy. "It is still under evaluation to see what role it plays in screening for colon cancer," says Dr. Mound. "But it looks promising."

Patients needing whole body scans: With the benefits of lung cancer and coronary artery detection making headlines, whole body scanning has became a popular request and the reason for the MDCT scan hype. A recent study from the Mayo Clinic found that random full torso scans of 1520 healthy individuals led to the diagnosis of more than a dozen lung cancers. In addition, 49 abdominal aortic aneurysms were identified, as well as three kidney cancers, 33 non-cystic kidney masses, and 24 renal stones. However, Dr. Mound still urges caution and a rational approach.

Children: With the recent headlines focusing on potential over-exposure to radiation for children who undergo CT scans, Dr. Mound responds to the debate with balance. He emphasizes that if your child, or any family member, is to have an x-ray or CT study, one should not hesitate to ask questions about the exam, especially if the reason for the exam is not obvious. The important point is that when performed for appropriate medical reasons, the benefit to the patient from a CT scan may far outweigh any risks.

As with all new technologies, the rush to use them, particularly for consumers who may not have enough information, is common. Dr. Mound urges, "While the MDCT scan provides high-quality pictures that make it possible to identify many abnormalities not possible before, consumers need to keep things in context. If they don't fall within any of the categories which might clearly benefit from CT scans, they should first discuss with their doctor whether a CT scan would be of any use to them before rushing out to get one."

Information for this article was provided by Encino-Tarzana Regional Medical Center.