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Health Team

Usefulness of CT scans called into question

Posted July 7, 2008

While CT (computed tomography) scans offer the best view of the heart, some doctors say they might not be the most useful.

Dr. Stephen Siegel, a cardiologist at New York University Medical Center, looks at thousands of hearts a year. Siegel said he has not had a patient whose life was saved through a CT scan.

The scan combines a series of X-rays to create an image of a beating heart. They give doctors a clear look at a patient's arteries, which is useful when heart disease is suspected. However, if there is no sign of trouble, there isn’t much the scan can be used for, Siegel said.

“Why get the information if you're not going to do anything with it,” Siegel added.

The scan also exposes patients to large doses of radiation and can cost up to $2,000.

No known studies prove that CT scans are better than older screening methods, which include blood work-ups and stress tests.

Despite the lack of studies, more hospitals have invested in the technology. Each CT machine is estimated at $1 million. Some say the high price tag could be an incentive to use scans even when they're not really needed – like for general screenings.

“It’s a new technology. It's a wonderful test. The question is, we have to find the best applications for it,” Siegel said.

Doctors have CT scanned hundreds of thousands of patients and the number looks to increase over the next decade.

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  • kchu1701 Jul 10, 2008

    CT scans probably are overprescribed, but so is every other medical test out there. I'm not surprised at Dr. Siegel's claim that he has had no patients whose lives have been saved by CT, because he is a cardiologist, and the most important CT applications are outside of his field. I doubt you can find many ER physician who would say the same thing.

    CT scans are also employed by oncologists for planning radiation therapy; since CT uses x-rays, just like the radiation that is meant to kill the cancer, the CT provides a useful guide for planning the radiation treatments.

    Also, even if the CT (or any other medical test) doesn't find the exact cause of an illness, it is vital to proper diagnosis to eliminate the wrong possibilities.

    As far as safety, one should always limit one's radiation exposure, but individual scans do very little to impact your cancer risk. A lifetime exposure to 250,000 mrems is believed to increase your cancer risk by 10%, and each CT scan deals about 1000 mrem.

  • whatelseisnew Jul 9, 2008

    I think if tests do not result in the physician being able to render a correct diagnosis, then the tests should be free of charge. Basically, you medical folks are still doing a lot of guessing and these tools just help you charge more for the guesswork. Of course, you do not admit that you are using a process of guesswork and elimination, but that is what is going on.

  • FE Jul 9, 2008

    Recently had CT scan - not heart-related but entire trunk of body nevertheless.

    What's this about "large dose of radiation" ?? Is that a valid worry? Input from medical person would be appreciated.

  • Cleanup on Aisle Cool Jul 9, 2008

    CT offers very fast, very clear imaging. Think trauma patients.

    If a patient is stable, however, i think an X-Ray for hard tissue imaging or MRI for soft tissue imaging would be ideal. Though, I'm sure there would be times when a CT image would be best.

  • batcave Jul 9, 2008

    with every ct scan you are more predisposed to liver ca.

  • seanwhalen Jul 8, 2008

    This certainly wasn't 'fair and balanced' reporting. (Even though I'm a little biased, since I know personally the value of ongoing CT scans in my own diagnosis.)

    CT is definitely not a 'general screening' tool, nor have I heard it recommended by any of my doctors for that. CT is (or should be) for advanced 'diagnostics' - one of many that can be used to diagnose problems and ultimately lead doctors to the 'most effective' treatment plan.

  • Steve Crisp Jul 8, 2008

    The use and application of the CT scan is also largely dependent on ones doctor.

    No matter what I have done to myself. I have yet to have a CT performed with the exception of my jaw when I started tooth implants. I have never had one done of any other body part.

    My mother, on the other hand, can stub her toe and her doctor is whipping out the CT scan orders.

    It sometimes amazed me that the woman does not glow in the dark.