Release date: 2007-11-30
"Super X-ray" can find heart disease
In Orlando, Florida, a device called "Super X-ray" showed great promise in its first large-scale test, and it is expected to be a screening for patients with heart disease symptoms. A cheap, fast, and painless test for heart disease. Professor Julie Miller of Johns Hopkins University said: "With this scanner, you can replace up to 1.3 million cardiac catheterizations in the United States each year to check for arterial obstruction." But this new type The scanner is still controversial.
There is debate between the US public health insurance department and private insurance companies that many cardiologists are opposed to the cost of this check. The focus of the debate is that the "super X-ray" scanner needs Use a fairly large dose of radiation. Professor Michael Lauer of the National Heart, Lung, and Blood Institute in the United States is concerned that if such devices are widely used in the population for screening, it will increase cancer and thousands of other diseases. At an American Heart Association meeting to showcase the results of the scanner, Professor Michael Lauer called: "Doctors should not use this test method until there is a definitive study to prove that this method can save lives."
Professor Miller, the head of the study, responded by saying: "I think his fears are a bit redundant. Because this 'super X-ray' scanner will only be used in a small number of patients who meet the test conditions, not like they Worried, for people who don't have any symptoms."
This new CT scanning technology has entered the market as early as 2 years ago and has been used by many hospitals. Because it uses 64 detectors to generate an image, the scanner is called a "64-layer CT." The image of the scanner is very detailed, and doctors say that the images are almost as clear as the surgical field of view.
In this new study, the current gold standard for the examination of patients' heart disease, angiography, was used in the cardiac catheterization laboratory and tested against the scanner. Test results show that the new scanner delivers a 10-fold higher dose of radiation to the patient than standard angiography. Although this technology has been used before, it has not proven its specific radiological data. This international study organized by Professor Miller is the first direct comparison of the two methods of inspection.
The researchers began research on 405 people suspected of having heart disease and eliminated about a quarter of them at the beginning because they were only too high in calcium on the arterial wall. As the age increases, the arteries become harder. This phenomenon is more common. Doctors worry that this phenomenon looks like obstruction, which may lead to biased examination results. Therefore, these patients are excluded from the study. . The researchers then performed this new CT scan on the remaining 291 subjects, followed by standard angiography. The results showed that 83% of the subjects had no obstruction; in patients with obstruction, 9/10 of them were found by scanning. Professor Miller said that this scan can eliminate the possibility of heart disease in nearly half of the patients, so they avoid the pain during the treatment, the cost of surgery and the risk of catheterization.
The American Heart Association spokesperson and cardiologist Professor Timothy Gardner said that the ability of the "Super X-ray" scanner to solve problems in a painless situation is "exciting", but the applicable population for this instrument The scope needs to be further determined. Professor Raymond Gibbons, former head of the Heart Association, revealed that the association recently sent a letter to public health insurance officials expressing disapproval of the use of this super scanner in patients without heart disease; Those who have heart disease or need to check for heart disease can consider using this scanner.
However, it is still said that the results of this study cannot change their opposition to this new technology. Professor Steven Nissen, an American cardiologist, said: "I won't buy it. If you have done this CT and found some problems, you still need to do a catheterization for angiography to confirm the diagnosis." In addition, he pointed out that In this study, the researchers deliberately selected patients who were most likely to have heart disease to perform this CT examination, resulting in obvious results.
The new scanner costs less than $1,000 and the cost of catheterization for angiography is $2,500 or more. More advanced scanners that will be available will provide 128 or even 256-slice CT images, which means more detailed images. At present, the debate between cardiologists who do angiography and radiologists who do this new scan is still inextricably linked. ——Shanghai Medical Device Industry Association website
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