Body Scans Not Always Needed

Q:  I am a 40-year-old healthy male. I am 5 to 10 pounds over ideal weight and have elevated cholesterol, which I have been treating with Lipitor for four years. I have made an appointment for an EBT whole-body scan with a local health-testing company. Do you believe this is a good diagnostic tool for me? Although I can afford the procedure, I don't want to throw my money ($750) away.

A:  This is a controversial issue that has divided the medical community and has physicians wondering what to advise their patients. EBT stands for electron beam tomography, which uses prisms to scatter the X-ray beam. This new technology results in a faster picture, thus allowing us to view the imaging of a beating heart. Another benefit is that EBT uses 30% less radiation than conventional CT (computerized tomography) scans.

Scanning centers, which first opened in California, have sprung up around the country in the past few years – especially in affluent areas – and are part of the latest medical fad to screen for cancer, heart disease and osteoporosis.

The American College of Radiology does not believe there is enough scientific evidence that body scans are cost-effective and prolong life. The American Cancer Society also cautions that there is a need for more data.

Looking for calcium in the coronary arteries is the most hotly debated use. The American College of Cardiology and the American Heart Association issued a statement in 2000 calling for more investigation. They agree that the procedure has potential and recommend its use – under the guidance of a physician – when the person's cardiac risk is intermediate or uncertain. A person who has a strong family history of heart disease but low cholesterol, normal blood pressure and a healthy lifestyle has a mixed picture.

The problem is that many people older than 65 have calcium in their arteries, resulting in a positive scan, but may not have blockage. Other people who are falsely reassured from a low calcium score do have narrowing and plaques that are not calcified. Howard N. Hodis, director of the atherosclerosis research unit at the University of Southern California School of Medicine, says there is not a direct correlation between calcium and atherosclerosis.

Hope this does not add to your confusion. You're healthy and presumably are lowering your cholesterol to good levels with Lipitor, so your scan will probably show a low calcium score because of your young age. Why pay $750 to find out what you already know? If you were 60 and had more risk factors, the scan might be a good idea.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.