"Super X-ray" can find heart disease

In Orlando, Florida, a groundbreaking device known as the "Super X-ray" showed promising results in its first large-scale trial, offering a potential new way to screen for heart disease. This fast, affordable, and non-invasive test could revolutionize how doctors detect arterial blockages. According to Professor Julie Miller from Johns Hopkins University, the scanner has the potential to replace up to 1.3 million cardiac catheterizations annually in the U.S., saving patients from discomfort and unnecessary procedures. However, the technology is not without controversy. The debate centers around the high radiation dose associated with the "Super X-ray." The U.S. National Heart, Lung, and Blood Institute’s Dr. Michael Lauer warned that widespread use of this device could increase cancer risks and other health issues. At an American Heart Association meeting, he urged caution, stating that doctors should not adopt the method until there's clear evidence it can save lives. Professor Miller defended the technology, arguing that the scanner would only be used on a small group of patients who actually need it, not for general population screening. She emphasized that the device is designed for those showing symptoms, not for asymptomatic individuals. This advanced CT technology, known as a "64-layer CT," has been available since 2005 and is already in use at many hospitals. Its detailed images are comparable to what surgeons see during operations. In a recent study, the scanner was compared directly with traditional angiography, the current gold standard for diagnosing heart disease. The results revealed that the new scanner delivers a 10-fold higher radiation dose than standard angiography, raising concerns about long-term safety. The study involved 405 participants suspected of having heart disease. About 25% were excluded due to high calcium buildup in their arteries, a common age-related condition that can mimic blockages. The remaining 291 underwent both the new CT scan and standard angiography. The findings showed that 83% had no blockage, and 9 out of 10 patients with actual blockages were correctly identified by the scanner. Professor Miller noted that the test could rule out heart disease in nearly half of patients, avoiding unnecessary pain, cost, and risk. Despite the positive results, some experts remain skeptical. Dr. Timothy Gardner, an American Heart Association spokesperson, called the scanner “exciting” but stressed that its target population needs further clarification. Meanwhile, former Heart Association leader Dr. Raymond Gibbons expressed concern over its use in people without symptoms, urging caution. Cardiologist Dr. Steven Nissen criticized the study, saying the results were skewed because researchers selected patients most likely to have heart disease. He also pointed out that even if the CT scan finds an issue, a catheterization is still needed for confirmation. While the scanner costs under $1,000 compared to $2,500 for angiography, the debate between cardiologists and radiologists continues. As more advanced models with 128 or 256 slices come into play, the discussion over safety, effectiveness, and appropriate use will likely intensify.

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