Times of India
11 May, 2010
BY Sumitra Deb Roy
Mumbai, India

A persistent muscular pain in the chest recently brought 44–year–old Ramesh Taurani to a hospital in Bandra where he was subjected to a CT scan. The results were a bolt from the blue.

A sedentary, corporate lifestyle had led to significant cholesterol deposition in all the three vessels of his heart. Two of his arteries had more than 80% blockage. All these, including the exact location of the blockage and the quantum, were accurately pointed out by the CT scan even before he underwent coronary angiography (angiography is the classic test needed to decide how the cardiac problem needs to be tackled further).

With the advent of new–age CT scan machines, though, there has been a raging debate on whether computerised tomography (CT) angiography can be a viable alternative to classic angiography, which has so far been the gold standard for blockages. Experts say a CT scan, which takes barely a few seconds to scan one’s body, can save an entire day required for angioplasty, which involves needles and anaesthesia.

According to senior consultant radiologist Dr Manoj Deshmukh of Lilavati Hospital, CT angiography findings about cardiac blockages are almost 95% as accurate as angiography. The hospital recently acquired a 914 slice CT scan machine that can scan the entire body in five to seven seconds and detect heart or brain clots accurately. Some radiologists also believe that cardiologists are gradually opening up to the idea of planning treatment based on CT scan findings rather then sending all and sundry for catheter angiography.

Currently, angiography is both diagnostic and therapeutic in nature. “A few years down the line, it may only be therapeutic,” said Dr Hemant Patel, chief radiologist of the GT hospital Imaging Centre.

Over the past few years, CT scan has advanced technologically by leaps and bounds. While public hospitals were introduced to 16 slice scanners, private hospitals went for 32 and 64 slice machines.

In March, the state–run J J Hospital became the first public hospital to own a 128 slice CT scan machine. “The technology holds promise for the future, which is why the state has opted to invest so much money in it,” said a senior professor at the hospital.

Cardiologists, though, say it is too early to write off angiography. “Multi–slice CT scans are definitely handy as the new ones can capture heart images even with a faster heart beat,” said Dr Dev B Pahlajani, head, interventional cardiologist, Breach Candy Hospital.

While performing an angioplasty, said Pahlajani, a cardiologist would need live images. Heart is a dynamic structure and it keeps on beating. So, live images are a must. He said that CT scan combined with stress test can be a great tool for first–level cardiac screening. As of now, angiography is an essential tool for coronary blockage treatment.

Decoding The Change

CT angiography is a minimally invasive medical test that produces pictures of major blood vessels in the body

It provides a multi–dimensional view of the blood vessels

Speed is one of the biggest benefits of the new–age CT scan

It exposes patients to less radiation as the scan is done in a few seconds