Scanning for truth
Total body CT scans are being heavily touted in the media as the newest way to quickly and painlessly screen for a wide variety of health problems. For high-risk individuals in particular, having a total body scan may be valuable.
The 15-minute computerized scan takes computerized tomography (CT) pictures of the whole body in "slices" and then compiles the images so that physicians can have a clear, detailed look inside the body. The scans are able to analyze four major areas of the body: the heart, lungs, abdomen and pelvis.
In the heart, the scan can detect an aortic aneurysm and reveal deposits of calcium in the coronary arteries. Research has shown a strong correlation between the presence of coronary calcification and atherosclerosis (coronary artery disease). More coronary calcium suggests a greater likelihood of significant narrowing somewhere in the coronary system.
Nonetheless, the presence of such deposits doesn’t necessarily mean that an artery is dangerously narrowed by disease or that a severe health threat exists. For example, calcium deposits are often found in older people as a result of their age. (The majority of men over age 60 and women over 70 will have calcium that can be seen on a CT scan.)
The CT scan cannot give as precise a location of the diseased portion of the artery as other tried-and-true imaging tests such as cardiac catheterization, nor can it detect a soft plaque that has been identified in current research as a major cause of heart attack.
Finally, a total body scan may demonstrate a finding that is questionable without further testing. Additional tests, some of which may carry a greater risk, may be necessary to clarify the scan’s results. For example, a scan may show calcium that, after further diagnostic testing, is attributable to the patient’s age rather than heart disease.
High-risk factors
If you are concerned about your risk factors for coronary artery, vascular, lung or abdominal and/or pelvic disease, or have already been diagnosed, please speak to your doctor about the value of a total body CT scan. High-risk factors include:
- an individual or family history of coronary artery disease
- an individual or family history of abdominal aneurysm
- smoking at least one pack of cigarettes a day for at least 10 years, regardless if you no longer smoke
- a history of high cholesterol, diabetes or high blood pressure
- being overweight
A total body CT scan also may benefit individuals who, for any number of reasons, are unable to access their family medical histories.
That being said, total body scans are useful in certain situations. For high-risk individuals, for example, the proposed benefit of having a total body scan lies in the potential of early detection and treatment. In general, the earlier a condition is diagnosed and treated, the greater the chance for long-term survival. In patients already diagnosed with coronary disease, scans can help evaluate calcium build up, and help doctors determine the severity of the disease and whether cholesterol-lowering medications should be prescribed. Scan results also can help physicians assess whether treatments for coronary disease are working.
It is important to remember that total body scans provide a "snapshot" in time of the anatomy of your body. The scan neither detects all disease, nor does it provide a guarantee that disease will not develop in the future. Also, like all forms of X-ray imaging, the total body CT scan poses some risk of radiation exposure.
Total body CT scans are performed at the Cleveland Clinic, and they are interpreted by board-certified radiologists specifically trained in cardiovascular, pulmonary, abdominal and pelvic diseases. If you decide to undergo a total body scan, you will receive a full, easy-to-understand report in the mail within a few days of the procedure. The report will outline your risk assessment and include any follow-up recommendations. If your scan shows any abnormalities, a nurse will call you. You may require further testing.
As with all medical records, CT scan results are kept confidential.
Because the scan is a screening tool, it currently is not covered under most major insurance plans or Medicare. Also, please note that additional follow up may or may not be covered by your insurance.
Do your research. Those who are looking at the total body scan to help determine their risk for heart disease, should also consider the cardiac calcium score test which is used to detect calcium deposits found in atherosclerotic plaque in the coronary arteries. The test is combined with a lipid analysis and complete risk assessment questionnaire, all evaluated by a cardiologist specializing in Preventive Cardiology, making it a more comprehensive method to determine risk for heart disease. As an educated consumer, you need to weigh the benefits against any potential risks of having a total body scan. Take into consideration your individual circumstances, including risk factors and family history. You, along with your physician perhaps, may decide what type of test would be most beneficial.
For more information:
- Whole-body CT screening for cancer and coronary disease: Does it pass the test? Michael Modic, MD, chairman of Radiology, offers his analysis in the new Cleveland Clinic Journal of Medicine.
Even though whole-body CT scanning is being marketed directly to patients and they are starting to demand it, does it meet the standards of a good screening test for cancer and coronary artery disease? This article is a step by-step, disease-specific discussion of the characteristics of a good screening test, and whether whole-body CT scanning meets these standards. Read the PDF of this expert point of view** by Michael Modic, MD, Cleveland Clinic's Chairman of Radiology, from the latest issue of The Cleveland Clinic Journal of Medicine.
- Total body CT scanning at the Cleveland Clinic.
* a new browser window will open with this link. The inclusion of links to other web sites does not imply any endorsement of the material on the web sites or any association with their operators.
If you need more information or would like to make an appointment with a specialist, contact us, chat online with a nurse or call the Miller Family Heart and Vascular Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.
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This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.
Copyright 2009 Cleveland Clinic. All rights reserved. 10/09
