Risks, Benefits OF Cardiac CT Scans

CBS Evening News: New Study Shows Dose Of Radiation Varies Greatly

(CBS)  Approximately 2.8 million Americans are expected to undergo cardiac CT scans this year. And the number of CT scanners installed in U.S. cardiology practices has tripled in the past two years. CBS News medical correspondent Dr. Jon LaPook looks at the risks versus the benefits.

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Fifty-five year old Paulette Caballero's father died of a heart attack. So when she had an abnormal cardiogram, her doctor wanted to know if she was headed in the same direction, CBS News medical correspondent Jon LaPook reports.

"My cardiologist recommended I do a CT scan," Caballero said.

The cardiac CT scan, which costs about $800, gives doctors clear 3D images of the coronary arteries without having to do an invasive angiography.

But the test exposes patients to potentially harmful radiation. Exactly how much has been unclear, prompting an international study with a surprising result.

"We found that the scanner output varied approximately six-fold between the different imaging sites," said the study's author, Dr. Thomas Gerber.

Patients can be getting radiation equal to 600 chest x-rays.

One reason for the wide variation: not every site is taking steps to reduce the radiation dose.

What's the lesson? "Educate the medical community what they can and must do to decrease the radiation dose from the tests they perform," Gerber said.

What are the radiation risks of this test?

"The primary radiation risks are the possibility of developing lung cancer or breast cancer at some point subsequent to the test," said Dr. Andrew Einstein of Columbia University Medical Center.

The government doesn't regulate the amount of radiation a patient gets during a cardiac CT scan, and the dose can vary widely.

It's up to a referring doctor to estimate what dose you'll be getting,

With CT scans, accounting for almost half of medical radiation, the American Heart Association Monday cautioned physicians to carefully balance the risks and benefits.

"Every CT we do in a patient that has very low risk and no symptoms, that's probably one too many," Gerber said.

Caballero's heart scan was normal.

"Everything was clear, and I'm happy about that," Caballero said.

She's also happy that her scan was low-dose - a goal yet to be realized everywhre.

[hanleymike]

Medical decisions always involve weighing the risks and benefits of a procedure or medication. CT scans that will potentially provide life saving information should not be avoided for fear of an assumed small increased risk of cancer. You can visit www.xrayrisk.com to calculate individual risk based on studies you have had.

[whentotrrt]

True ct scans have come a long way. but people must understand the risk they undergo. their is this invisible danger, which u cant feel right away. takes a lot of years to manifest. but it is their. clear and present.

just ask ur doctors before undergoing procedures if it is necessary especially if u come in thru the E.R.

[xraybonz]

while the benefits of medical imaging have helped tremendously over the past several years, the risk of excessive and unnecessary radiation is an issue with the increasing use of CT, in particular, to diagnose patients. The study shows the large variation in dose and I believe may be in part due to the wide range of education, training and licensure or lack thereof, of medical imaging technologists. There are no minimum standards required for us to perform these types of exams. Therefore, you may be in a state that utilizes 18 year old kids to operate a CT scanner, instead of a technologist educated by at least a two year accredited program with the proper training and subsequent licensure following examination by a national registry such as the ARRT. I perform CT and MRI, i am fully licensed and credentialed not only in radiography, but in CT and MRI. This is what the standard should be and hopefully with legislation pending in Washington we will have that happen. Ask your health care provider who is doing their xray or CT scan. Make sure it is someone who has been educated and trained properly to ensure that you or your family are not overexposed to unnecessary radiation and that your examination is of diagnostic quality.

[ljb6599]

I am just so sick and tired about all these stupid arguments about scanning technolgy.Everything we do can have some risks.Lets just stop all this technology,people will die earlier and that will help the economy and the health care situation.

[runinturtle]

The risk of excessive radiation dose to the heart is REAL. As a Hodgkins Disease patient long ago, my treatment was total nodal radiation, which was appropriate at the time. This included irradiating the clump of lymph nodes just above the heart. Fifteen years later, I underwent 5-way bypass surgery, due to severe coronary artery disease. It was attributed to radiation-induced damage from the previous therapy. See this link:
http://jama.ama-assn.org/cgi/content/abstract/270/16/1949?ijkey=f7eb595982b6ee954f8a33243df41ca04da541ef&keytype2=tf_ipsecsha