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The News in Medical Tests

October 4, 2009

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>Virtual Colonoscopy Also known as CT colonography, this test uses X-rays to produce images of the colon and any polyps growing there. Patients perform the same bowel clean-out required with a traditional colonoscopy, but the test is quicker and doesn’t involve a scope or sedation. Several recent studies show that virtual colonoscopies accurately detect polyps. If polyps are found, the patient must then undergo a colonoscopy to remove them. Medicare doesn’t cover this CT procedure. -- Erin O’Donnell

>BREAST MRI The American Cancer Society now recommends that women at high risk for breast cancer -- including those with BRAC1 or BRAC2 gene mutations -- receive a breast MRI with their annual mammogram. Dr. Eric Winer, an oncologist with the Dana-Farber Cancer Institute, says an MRI is also useful when a mammogram is unclear. But because the procedure can yield false positives, triggering unnecessary biopsies, Winer says more research is needed before the test is routine.

-- E.O.

>Heart UltrasoundCT scans and MRIs may be popular tools for treating heart disease, but Dr. Thomas Risser, director of the cardiac noninvasive lab at Cambridge Health Alliance, predicts that heart ultrasound (or echocardiography) will grow increasingly important. Heart ultrasounds are inexpensive, usually covered by insurance, and don’t expose patients to the ionizing radiation in CT scans, he says. They allow doctors to see how blood flows through the heart, check its structure, and assess damage after a heart attack. -- E.O.

>Prostate Cancer Screening Last summer, the US Preventive Services Task Force announced new recommendations, urging men 75 and older to skip prostate cancer screening. The advice is based on the fact that prostate cancer treatment can lead to incontinence and erectile dysfunction, problems that for this age group outweigh the risks of the cancer, which is usually slow growing. The task force also said there’s not enough evidence to recommend for or against prostate-specific antigen testing in younger men. -- E.O.

The News in Medical Tests >Coronary CT Angiography This technology uses X-rays to scan the heart and arteries, producing 3-D images and a clear view of any arterial plaque. The scan takes just seconds but, like all CT scans, exposes patients to a dose of radiation, says Dr. Thomas Risser, director of the cardiac noninvasive lab at Cambridge Health Alliance. This is less concerning if a patient receives a single scan, but Risser says it may be harmful if a person needs frequent scans. -- E.O.

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