Com­puted To­mog­ra­phy (CT) Scan

Insurance - - ADVERTORIAL - by Dr Lim Aik Boon Ra­di­ol­o­gist


om­puted To­mog­ra­phy (CT) is an imag­ing method that uses x-rays and com­puter to cre­ate cross­sec­tional pic­tures/im­ages of the body. It has been used as med­i­cal imag­ing since 1972 and has evolved into the 4th gen­er­a­tion presently. CT has de­vel­oped from sin­gle slice CT to multi-slice CT (MSCT) and dual source CT over a du­ra­tion of 39 years. There is great im­prove­ment in speed, pa­tient com­fort and res­o­lu­tion with the present gen­er­a­tion of CT. With this ad­vanced tech­nol­ogy, CT pro­vides ex­cel­lent im­age qual­ity for di­ag­nos­tic con­fi­dence at the low­est pos­si­ble ra­di­a­tion dose. A whole body CT will take about 30 sec­onds to com­plete with 64 MSCT. CT pro­vides greater clar­ity and re­veals more de­tails than reg­u­lar xray/ul­tra­sound ex­ams of in­ter­nal or­gans, bones, soft tis­sue and blood ves­sels. It helps doc­tors and ra­di­ol­o­gists to di­ag­nose can­cers, car­dio­vas­cu­lar dis­ease, in­fec­tious dis­ease, ap­pen­dici­tis, trauma, mus­cu­loskele­tal dis­or­ders etc.


CT can be used to scan any part of the body. It is one of the best and fastest tools for study­ing the chest, ab­domen and pelvis be­cause it pro­vides de­tailed, cross-sec­tional views of all types of tis­sue. Com­monly done CTs are head, neck, chest, ab­domen and pelvis. CT is mainly used to solve clin­i­cal prob­lems. Physi­cians of­ten use CT ex­am­i­na­tion to: Quickly iden­tify in­juries to the lungs, heart and ves­sels, liver, spleen, kid­neys, bowel or other in­ter­nal or­gans in cases of trauma. Guide biop­sies and other pro­ce­dures such as ab­scess drainages and min­i­mally in­va­sive tur­mour treat­ments. Plan for and as­sess the re­sults of surgery, such as or­gan trans­plants or gas­tric by­pass. Stage, plan and prop­erly ad­min­is­ter ra­di­a­tion treat­ments for tu­mour as well as mon­i­tor­ing the re­sponse to chemothe­r­a­phy. With tremen­dous re­search and de­vel­op­ment in CT, health screen­ing us­ing CT is gain­ing mo­men­tum and is more ac­cept­able. New gen­er­a­tion of CT of­fers good di­ag­nos­tic im­age qual­ity with low ra­di­a­tion dose. Cur­rently, low dose CT lungs, CT colonog­ra­phy and car­diac CT for cal­cium scor­ing and coro­nary an­giogram can be of­fered as health screen­ing tool with guide­lines. Many stud­ies had proven that th­ese screen­ing CT help to re­duce mor­bid­ity and mor­tal­ity as well as health­care cost. Lung can­cer is the 3rd com­mon­est cause of can­cer death in Malaysia. In the United States, the life­time risk of de­vel­op­ing in­va­sive lung can­cer is 1 in 17 for men and 1 in 18 for women. It is es­ti­mated that over 80% of lung can­cers could be cured if de­tected at an early stage. CT is more sen­si­tive than chest X-ray in de­tect­ing lung can­cer. Stud­ies show that there are 20% fewer lung can­cer deaths in those screened with low-dose MSCT com­pared to chest Xray.

The in­di­ca­tions for screen­ing CT lungs are:

His­tory of lung can­cer 10 packs/year or more smok­ing his­tory (1 pack of cig­a­rettes per day for 10 years, 2 packs of cig­a­rettes per day for 5 years, etc.)

Past his­tory of smok­ing (less than 10 years ago)

Re­peated ex­po­sure to sec­ond­hand smoke Ex­po­sure to other can­cer-caus­ing agents (e.g. as­bestos and radon)

Age more than 40 years Col­orec­tal can­cer is the 2nd com­mon­est cause of death due to can­cer in Malaysia. Col­orec­tal can­cer is the third most com­mon can­cer di­ag­no­sis in the United States and the sec­ond lead­ing cause of can­cer-re­lated deaths. Each year, about 150,000 peo­ple are di­ag­nosed with colon can­cer, and about 50,000 will die of it. How­ever, if de­tected early, the 50-year sur­vival rate for colon can­cer ex­ceeds 90%. Re­cent data stud­ies showed CT colonog­ra­phy is com­pa­ra­ble to op­ti­cal colono­scopoy for the de­tec­tion of can­cer and polyps of sig­nif­i­cant size (more than 1 cm).

The in­di­ca­tions for CT colonog­ra­phy screen­ing are:

Older than 50 years

Have had polyps in the past

Fam­ily his­tory of colon can­cer

Test pos­i­tive for blood in the stool El­derly pa­tients who are frail or in­firm – dif­fi­cult for colonoscopy. When colonoscopy is at­tempted but in­com­plete be­cause the full lenght of the colon is not vi­su­alised, CT colonog­ra­phy may be done on the same day. If a tu­mour is found on colonscopy and it blocks pas­sage of the scope, CT co­long­ra­phy will per­mit a thor­ough check of the en­tire colon.

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