Navigation Links
CT Scans Can Spot Blocked Arteries

But debate continues as to whether they are worth the expense

WEDNESDAY, Nov. 26 (HealthDay News) -- Expensive, high-tech CT devices that produce 64-slice images of arteries are almost, but not quite, as good as the standard method of detecting and gauging blood vessel blockages, a study finds.

Therefore, "multidetector CT angiography cannot replace conventional coronary angiography at present," concludes a report in the Nov. 27 issue of the New England Journal of Medicine.

But if that is so, experts ask, why is Medicare continuing to pay for these pricey CT exams?

"There is no evidence that they are of benefit to patients," said Dr. Rita F. Redberg, professor of medicine at the University of California, San Francisco, co-author of an editorial in the journal. "In general, there should be evidence of benefit before there is widespread use," she said.

Nevertheless, the study's lead author said the scans may have a place in cardiovascular care.

"Our study shows they do have value, because they have a high degree of diagnostic accuracy to identify patients with tight heart blockages," said Dr. Julie M. Miller, assistant professor of medicine at Johns Hopkins University. "Having the scan is a noninvasive procedure, and that is very attractive. Patients do not undergo the risk, even though it is small, of angiography."

Angiography, which requires insertion of a slim catheter tube into the blood vessels, is the typical way physicians gauge the degree of artery blockage to determine whether treatment is necessary. "Our paper shows for the first time that 64-CT scans can identify patients who need to go on to angioplasty and bypass procedures," Miller said. "It has diagnostic accuracy compared to other tests, such as stress testing. They create more invasive catheterizations than are needed than if the 64-CT test is used."

The study of 291 people with suspected coronary artery blockages was done at nine U.S. medical centers. They underwent both 64-CT and conventional coronary angiography.

The CT scans accurately predicted 84 percent of the treatment procedures that were required, compared to 82 percent accuracy for angiography.

"Until now, there has been doubt about 16-row or 64-row CT scanners being able to diagnose coronary disease," Miller said. The new study dispels that doubt, she said.

But there is no evidence that using a 64-CT scan changes the outcome, Redberg countered. "We need to have a study that uses CT and the traditional strategy and look at the outcome in the two arms to see which is better," she said.

This is more than an argument between academics. Aside from the health of people who might have CT scans, a great deal of money is involved. Redberg's editorial tells a tangled story of how the national Medicare program first declined coverage of the CT scans, asserting at the time that the "evidence is inadequate" to prove their value. However, a series of local decisions means Medicare now covers the scans in every state.

In fact, "the use of cardiac imaging has been increasing by 26 percent per year, despite a lack of evidence of outcome benefit," the editorial said. "Without such evidence, a high-resolution CT angiographic CT image of the heart is just another pretty picture," the expert said.

CT scans also expose patients to a relatively high dose of radiation, the editorial noted, citing a study which estimates that 1.5 percent to 2 percent of all U.S. cancer cases may be attributed to CT radiation.

However, Miller believes that CT scans do have a role in diagnosis.

"The cost to patients is generally reasonable when compared to other noninvasive imaging tests and cheaper than catheterization in general," she said. CT scans of the heart can be considered "for someone complaining of angina [chest pain] who needs further noninvasive evaluation, instead of a stress test, or patients who have had a previous stress test where the results were not clear."

More information

There's more on coronary angiography at the U.S. National Library of Medicine.

SOURCES: Julie M. Miller, M.D., assistant professor, medicine, Johns Hopkins University, Baltimore; Rita F. Redberg, M.D., professor of medicine, University of California, San Francisco; Nov. 27, 2008, New England Journal of Medicine

Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Brain Tumor Awareness Day: Free Brain Scans to Promote Early Detection
2. Brain scans demonstrate link between education and Alzheimers
3. Brain Scans Show Bullies Enjoy Others Pain
4. Scans Reveal Brain Abnormalities in Fibromyalgia Patients
5. PET scans lead to treatment changes in majority of colorectal cancer patients
6. PET scans help identify mechanism underlying seasonal mood changes
7. New Test Scans Beef for Mad Cow Disease
8. Breast CT Scans Could Be Comfortable Alternative to Mammograms
9. New study finds coronary arterial calcium scans help detect overall death risk in the elderly
10. Brain Scans Detect Alzheimers Disease Quickly
11. Arterial Calcium Scans Can Predict Death Risk
Post Your Comments:
Related Image:
CT Scans Can Spot Blocked Arteries
(Date:11/28/2015)... ... 2015 , ... Pixel Film Studios is back again with ProPanel: Pulse ... are endless. Users have full control over angle of view, speed method, start point, ... sure to get heads to turn. , ProPanel: Pulse offers fully customizable pulsating shape ...
(Date:11/27/2015)... ... November 27, 2015 , ... According to an article ... way that they are handling security in light of the recent terrorist attacks in ... an attempt to stop an attack from reaching U.S. soil. Especially around special events ...
(Date:11/27/2015)... ... November 27, 2015 , ... ... were," said an inventor from Hillside, N.J. "Many people catch diseases simply from ... that individuals will always be protected from germs." , He developed the patent-pending ...
(Date:11/27/2015)... ... ... Herpes-only dating community in the world, revealed that over 50% of its members are under ... under the age of 50 – or 67% of the population - are infected with ... infection . , "The data shocks us highly!" said Michelle Li, Co-Founder of the ...
(Date:11/27/2015)... MINNEAPOLIS, Minn. (PRWEB) , ... November 27, 2015 ... ... you start failing. Secura Consultants has prided itself for not only fulfilling the ... best income protection solutions at an affordable price and providing top-tier customer service. ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... , 26 november 2015 AAIPharma ... de geplande investering aan van ten minste ... laboratoria en het mondiale hoofdkantoor in ... zal resulteren in extra kantoorruimte en extra ... de groeiende behoeften van de farmaceutische en ...
(Date:11/26/2015)... FRANCISCO , November 26, 2015 ... billion by 2022, according to a new report by Grand ... Chronic Kidney Disease (CKD) which demands kidney transplantation is expected ... and cost effective substitute for organ transplantation. --> ... billion by 2022, according to a new report by Grand ...
(Date:11/26/2015)... 26, 2015 ... ser potential att använda SyMRI för att ... för patienter med multipel skleros (MS) eller ... SyntheticMR AB för att kunna använda SyMRI ... Med SyMRI kan man generera flera konstrastbilder ...
Breaking Medicine Technology: