New scanner gives doctors latest edge
By Kyle Jorrey kjorrey@theacorn.com

IN-DEPTH IMAGING—Radiologist Roy Gottlieb of Rolling Oaks Radiology examines a high-tech angiogram of the coronary arteries of a patient. The equipment enables diagnosis without catherization. BILL SPARKES/Acorn Newspapers

In the modern age of healthcare, the name of the game is early detection.

Gone are the days when it was acceptable for doctors to simply sit back and wait for symptoms to present themselves before diagnosing the patient and beginning treatment. Heightened understanding of the human body and advancements in examination technology have made it possible for medical professionals to detect many diseases at their earliest stages—even before symptoms arise—dramatically increasing the likelihood of successful treatment.

“How much am I really helping a patient if I find lung cancer that’s spread all over the place?” said Roy Gottlieb, MD, medical director of Rolling Oaks Radiology in Thousand Oaks. “Early detection is the key to healthcare everywhere.”

With that goal in mind, Gottlieb and the staff of Rolling Oaks are excited about their 64 Multi-Slice CT Scanner, a new piece of equipment that gives doctors a clearer and more detailed view of the human heart and its vessels when patients get a CT angiography.

The CT angiography is a noninvasive examination using Xrays and computer technology to visualize blood flow in the arterial and venous vessels throughout the body. One of its purposes is to reveal any narrowing of the arteries (atherosclerosis), a sign of coronary artery disease that can lead to a heart attack.

The new scanner, Gottlieb said, is another tool in the fight against heart disease, the No. 1 killer of men and women in America.

The scanner’s results can give physicians a definitive answer as to whether or not heart disease is present long before any noticeable symptoms, such as chest pain or shortness of breath, appear.

When asked if the new technology would actually save lives, Gottlieb said, “No question.”

“It allows us to actually look for plaques in the vessel, even before they cause any significant narrowing,” Gottlieb said. “And not only can we see calcified, or hard, plaque, but we can see the soft plaque as well. The soft plaques are the ones that are more likely to break off and cause coronary events.”

Other CT scanners can only show hard plaque, which is soft plaque that has become calcified over time. By revealing the presence of soft plaque, the new scanner allows doctors to notify patients sooner that they have coronary artery disease and need the medicine to treat it.

“Now we can pick it up earlier . . . and help stratify certain patients who may first need to be put on aggressive medicine, such as Lipitor,” Gottlieb said.

The data obtained from the scanner is examined by trained radiologists on a high-powered computer. It reveals a 3-D image of the patient’s heart, which can be manipulated in countless ways to give the doctor and the patient the best view of at-risk arteries.

The sight of a narrowed passageway to the heart is a powerful tool, Gottlieb said, especially for physicians with stubborn patients who are skeptical about taking expensive medicine for the rest of their lives.

“There’s a big difference with being told, ‘You know your cholesterol levels are high and you have to stay on this medicine forever’ and being shown a picture of your coronary artery,” Gottlieb said.

“Then I can say, ‘Here, you see that vessel, it’s narrowed here. See all that plaque; you’ve got coronary artery disease. No question about it. You need to stay on that medicine or that’s going to get worse.’

“Then you put that little picture of your heart by your toothbrush in the morning, next to your bottle of Lipitor or whatever, and every time you brush your teeth you remember, ‘I’ve got to take this,’” he said.

Gottlieb suggested anyone interested in getting this study done should consult their family physician. The procedure isn’t for everyone: a family physician can look at the total picture of a patient’s medical history and then decide if the study would be beneficial or not.

For some patients, the study could be an alternative to a much more invasive catheter angiography, which involves passing a catheter through the groin into the heart and then injecting a contrast material.

The 64 Multi-Slice CT Scanner, in contrast, works in seconds and is painless.

“You go on the table, take one full breath, hold in, and you’re done,” Gottlieb said.

But it’s a costly few seconds. The study costs around $1,000 and so far very few insurance companies know enough about the scanner to include it in the coverage.

All of this is even more reason for a patient to consult a physician before doing the study. Rolling Oaks is currently accepting only patients who have a doctor’s referral to use the machine.

“It’s a great test for the correct population,” Gottlieb said, “but it’s not for everybody.”

Even so, the new scanner is another tool for healthcare providers to try to stop a deadly disease in its tracks.

“Studies have shown, if you can catch it early on, that with aggressive medical management, and good diet and exercise, the amount of soft plaque will regress,” Gottlieb said. “This test can give you that heads up.”