Computed Tomography Exams

Computed tomography (CT) uses X-rays in conjunction with a computer, producing cross-sectional images of body parts. CT generated images can distinguish small differences in tissue densities, as well as manipulate the images, both functionalities a conventional X-ray does not have. It is necessary to give oral and intravenous contrast materials for some exams, as the contrast highlights the intestines and soft tissues of the body to provide a better view of these structures. A technologist is always available to explain the study and make your patients’ experiences as comfortable as possible.

PREPARATION:

CT scans of the sinuses, extremities or chest do not require any preparation.

All other types of exams (i.e. head, abdomen, pelvis) require no eating, drinking, chewing gum or smoking four hours prior to the study except for prescribed medication.

This exam is performed at all our locations.

A heart scan is a very fast CT scan of the heart. This new technology uses sophisticated software with a sub-second CT scanner to detect small amounts of calcium in the coronary arteries. The test is quick, simple and non-invasive.

Coronary artery disease (CAD) is the leading cause of death in the United States. CAD occurs whenever arteries that carry oxygenated blood to the heart become clogged with plaque. The plaque build-up slows the blood-flow to the heart and increases the risk of myocardial infarction. Patients are usually diagnosed after they develop symptoms and display an abnormal response to invasive testing. Unfortunately, by that time, the atherosclerotic process is advanced and the opportunity for prevention has been missed.

Coronary Artery Calcification Scanning determines very accurately the presence and the severity of coronary artery calcification. Extensive research has determined that the presence of calcium in the coronary arteries is a good predictor of underlying heart disease. A calcium score >400 implies the presence of extensive CAD with a likelihood >90% of at least one significantly obstructed vessel. While calcium is a marker for CAD, it is important to remember that not all plaque is calcified and a negative heart scan does not mean a person is free of heart disease.

Here at St. Joseph’s Imaging Associates, we assess cardiac calcium using General Electric’s Lightspeed VCT 64 slice scanner; the software Vitrea, quantifies the calcified plaque in the calcium score guidelines. Here it is important to note, the clinical significance of a particular score is influenced by a patient’s age and gender. We encourage patients to work with their physicians to determine the significance of their CAD scores and to make changes in the assessment of their risk factors for heart disease.

A heart scan may be useful in evaluating CAD in asymptomatic patients who have one or more risk factors for heart disease. A heart scan is not recommended for patients with known CAD, patients who are pregnant or patients with abnormally fast resting heart beats (tachycardia). In general, most studies have evaluated patients between the ages of 40 and 70. Clinical benefit is unlikely to be substantial in patients above the age of seventy and heart scanning is not recommended for these individuals.

A virtual colonoscopy, the CT alternative to a conventional colonoscopy, uses computed tomography (CT) to examine the colon and rectum for presence of cancer or pre-cancerous polyps. Virtual colonoscopy can disclose tumors, bleeding, inflammatory bowel disease and diverticulosis.

A small soft tip rectal tube is placed to allow air into the colon. The patient is then scanned, first lying face up and then face down on the CT table. The recorded CT images are then assembled using a computer program that creates both 2 and 3-dimensional models that the radiologist examines for polyps and other colon abnormalities. The entire examination should take no longer than 30 minutes to complete.

To prepare for a virtual colonoscopy, the patient should follow a two-day low residual diet and use a bowel preparation kit obtained at one of our offices. Because no sedation is used for the exam, the patient may resume normal activity at its completion.

This exam is ONLY performed at our North, Northeast, West and MOC locations.

Startling as the facts may be, only 16% of lung cancers are diagnosed at their earliest, most curable stages. However, if caught early, patients can increase their treatment options, outcome and survival rate. Recent efforts from the National Cancer Institute aim to change survival rates. Their eight year trial, the National Lung Screening Trial (NLST), of 53,000 smokers and ex-smokers has shown that using CT for screening of lung cancer instead of a chest X-ray has reduced cancer deaths from lung cancer by 20% over just five years.

Patients to benefit from screening LDCT for Lung Cancer (High Risk Patients)

• Age 55-77 years old with greater than or equal to 30 pack year history of smoking and if former smoker with a smoking cessation of less than 15 years
• Age greater than or equal to 50 with a greater than or equal to 20 pack year history of smoking plus one additional risk factor

Beneficiary eligibility criteria (All of the following criteria must be met)

• Age 55 – 77 years old
• Asymptomatic (no signs of symptoms of lung cancer)
• Tobacco smoking history of at least 30 pack years
• (one pack year = smoking one pack per day for one year; 1 pack = 20 cigarettes)
• Current smoker or one who has quit smoking within the last 15 years
• Receives a written order for LDCT lung cancer screening

Cost
SJIA will bill the patient’s insurance. However, if their insurance does not cover the exam, the payment will be the patient’s responsibility. Medicare will cover annual screenings for those that meet the criteria. If there are abnormal findings on the initial exam, and follow up procedures are required, they will need to be approved by the patient’s insurer.

Frequently Asked Questions

What is the difference between LDCT and a regular CT of the chest? LDCT significantly reduces the radiation exposure to the patient compared to a standard CT

Why don’t I always get LDCT? Although the radiation dose is reduced, the image quality is slightly inferior to a standard CT. The image quality is adequate for the purpose of screening for lung cancer but not as good for other diseases of the chest

Do I need to get contrast through an IV in my arm? NO

How long does this test take? 10 minutes

If the results state that there are abnormal findings on my exam does that mean I have lung cancer? One out of every three patients will likely have findings on the CT scan that may require additional follow up. The vast majority of these findings will not turn out to be cancer. 

Who should I contact if I have any questions after the exam? Contact your primary physician. The complete report will be sent to the primary physician provided by you before the exam. The report will contain not only all the findings from the exam, but also recommendation for follow up. Your physician will need to be involved in ordering any additional tests.

How much does a LDCT cost? SJIA will bill the patient’s insurance. However, if their insurance does not cover the $500 exam, the payment will be the patient’s responsibility. Medicare will cover annual screenings for those that meet the criteria. If there are abnormal findings on the initial exam, and follow up procedures are required, they will need to be approved by the patient’s insurer.

Should I get screened? 

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For questions about LDCT or to schedule an exam: Call 315-452-2004.

For more information please visit The American Lung Association.