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Obesity Hinders Medical Diagnostic Tests

Increased obesity in the United States has almost doubled the number of inconclusive diagnostic imaging exams during over a 15-year period, according to a study featured// in the August issue of Radiology.

Researchers assessed all radiology exams performed at Massachusetts General Hospital (MGH) between 1989 and 2003 to determine the effects of obesity on imaging quality and diagnosis.

In an effort to quantify how obesity affects diagnostic imaging quality, Dr. Uppot and colleagues analyzed radiology records from a 15-year span at MGH. They searched for incomplete exams that carried the label 'limited by body habitus,' meaning limited in quality due to patient size.

'While 0.10 percent of inconclusive exams were due to patient size in 1989, by 2003 the number had jumped to 0.19 percent, despite advances in imaging technology,' said Raul N. Uppot, M.D., lead author and staff radiologist at MGH. 'Americans need to know that obesity can hinder their medical care when they enter a hospital.'

An estimated 66 percent of adults in the United States are overweight, obese or morbidly obese, according to the Department of Health and Human Services. Additionally, more than 12.5 million American children and adolescents are overweight. Hospitals are feeling the strain--they now require larger wheelchairs and beds. Additionally, standard operating tables and imaging equipment are not suited for obese patients.

By 2003, the modality that yielded the most difficulties in rendering a diagnosis was abdominal ultrasound (1.90 percent), followed by chest x-rays (0.18 percent), abdominal computed tomography (CT), abdominal x-rays, chest CT and magnetic resonance imaging (MRI) (all anatomic regions included).

CT and MRI can be problematic because of weight limitations of the imaging table and the size of the opening on the imager (patients are inserted through a small 'hole in the doughnut'). Standard CT tables can
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