Ultrafast CT (Computed Tomography) Scan

In conventional x-rays, a beam of energy is aimed at the body part being studied. A
		plate behind the body part captures the variations of the energy beam after it passes through skin, bone, muscle, and other tissue. While much information can be obtained from a regular x-ray, a lot of detail about internal organs and other structures is not available. In computed tomography (CT or CAT) scan, the x-ray beam moves in a circle around the body allowing many different views of an organ or structure, and providing much greater detail. The x-ray information is then sent to a computer that interprets the x-ray
	regular x-ray	data and displays it in 2-dimensional form on a monitor.

Since their advent more than 25 years ago, CT scans have become the gold standard
for imaging many of the body’s internal organs. However, CT scans have never been particularly useful for imaging the heart because the heart is in nearly constant motion. Since CT scanners take several minutes to acquire the image, anything that moves
during this time becomes blurred.


New Technology

A new technology called ultrafast CT (computed tomography) is becoming more common recently to diagnose heart disease. Ultrafast CT (also called EBCT or electron-beam CT) can take multiple images of the heart within the time of a single heartbeat, thus providing much more detail about the heart's function and structures, while also greatly decreasing the amount of time required for
a study. Ultrafast CT can detect very small amounts of calcium within the heart and the coronary arteries. This calcium has been shown to indicate that lesions which may eventually block off one or more coronary arteries and cause chest pain or even a heart attack are in the beginning stages of formation. Thus, ultrafast CT scanning is being
used by many physicians as a means to diagnose early coronary artery disease in certain people, especially persons who have no symptoms of the disease. 

Why is ultrafast CT performed?

An ultrafast CT scan may be scheduled for:

• suspected mass or tumor within the heart.

• suspected aortic aneurysm (a weakened spot in the wall of the aorta, the main artery which carries oxygenated blood away from the heart to the body).

• assessment of heart tissue damage after MI (myocardial infarction, or heart attack).

• assessment of the patency (openness) of coronary artery bypass grafts.

• assessment of the pericardium (the outer sac surrounding the heart).

• assessment of suspected congenital conditions of the aortic arch (the arch-like portion of the aorta).

• assessment of suspected aortic dissection (tearing of the lining of the aorta).

How is ultrafast CT done?

Ultrafast CT is usually performed on an outpatient basis. There is no preparation necessary prior to the procedure, although each hospital may have slightly different protocols in place.

Generally, the patient is free to leave immediately after the procedure is completed. The patient may be asked to wait for a short time while the radiologist reviews the scans to make sure they are clear and complete. If the scans are not sufficient enough to obtain adequate information, additional scanning may be necessary.
 

From the American Heart Association:

Ultrafast CT (EBCT) can measure calcium deposits in the coronary arteries. The amount of calcium detected by EBCT is related to the amount of underlying coronary atherosclerosis (ath"er-o-skleh-RO'sis). The coronary calcium score, derived from EBCT scans of the coronary arteries, is known to predict the occurrence of cardiac events, such as fatal and nonfatal heart attacks or the need for coronary bypass surgery or coronary (balloon) angioplasty over the next one or two years. A negative calcium score implies a very low risk for obstructing coronary lesions and has a high negative predictive value for coronary events.

"If a person has coronary atherosclerosis, more intensive efforts to lower cholesterol levels and decrease other risk factors should be undertaken. For example, drug treatment to lower cholesterol and changes in lifestyle through improving diet, exercising and quitting smoking."
 

Advertisements for computed tomography (CT) are appearing in the media
and they can be quite seductive: "Come in and with our high technology CT scanner, let us see whether you have calcium deposits in the arteries of your heart. You feel fine now? You'll feel even better after the test if you know
you do not have any calcium deposits. That would mean you have a very low chance of having a heart attack — and you can enjoy your cheeseburger without fear or shame."

However, there are a couple of problems. The first is that you will almost surely have to pay for the test yourself. The charge will range from $200 to $1200, and insurance
almost surely will not cover the cost. You probably will be asked to pay with cash or a credit card before the test is done.

There are research studies under way examining whether this test can help identify patients who would benefit from drugs or cardiac procedures. But, right now, no one can assure you that you'll get the peace of mind you want, even if you actually have a very good cardiac outlook. There is a fairly high chance you will get alarmed by the test
result, and undergo tests and treatment of unknown benefit.

So, if you do undergo EBCT, do it with your eyes (and wallets) open. You are buying a procedure that may not provide the assurance you would like. Consider getting it at a site where they are doing research to study if and how the test actually can help people live longer. For additional information on utrafast CT screening and whether it might be
of benefit in your particular case, it is recommended that you seek the advice of your physician.