Sophisticated radiologic treatments like high-speed computed tomography (CT) scans now are being used both as an alternative to traditional surgery and as a new diagnostic tool for a number of common ailments. Typically administered by interventional radiologists, these treatments are available at most medical centers across the US.
Three leading experts discuss these new therapies below…
Cancer treatment JeffGeschwind, MD
When surgical removal of a malignancy of the liver, kidneys, bone or other organs is not an option, due to the size or location of the tumor, patients may now receive a new therapy called radiofrequency ablation.
What’s involved: An interventional radiologist uses an ultrasound to locate the tumor. A needle is then placed through the skin directly into the malignancy. A radiofrequency current is emitted through the needle to burn away the tumor without damaging any surrounding tissue. The treatment typically takes one to three hours and can be performed as an outpatient procedure, without general anesthesia.
Typical cost: $13,000 to $20,000.
Important: Radiofrequency ablation is only appropriate for the smaller malignancies that is, tumors no larger than 3 to 4 centimeters (cm) in diameter. This procedure is not a cure for cancer but can be used to help control it.
Approximately 25% of all American women and 10% of American men suffer from varicose veins. These will occur when a vein’s emptying mechanisms malfunction, resulting in reflux (the pooling of blood), most often in the legs or pelvis. Besides being unsightly, varicose veins also can lead to chronic pain.
A new image-guided technique called vein ablation, done with radiofrequency or laser heat, now makes it easier to destroy varicose veins without surgery or the injection of chemical solutions.
What’s involved: Guided by ultrasound, the radiologist threads a small catheter into the varicose vein. The laser is then fired briefly, which heats and seals the vein. The treatment takes less than an hour, and the patient is up and walking 20 minutes later.
Typical cost: $2,000 to $3,000 per leg.
Another new technique uses image-guided therapy to eliminate varicose veins in the pelvis. Some nine million American women suffer from unexplained chronic pelvic pain.
Pelvic congestion syndrome is a condition that has traditionally been very difficult to diagnose and thought to be unbeatable. Doctors now believe that many of these cases are caused by varicose veins in the pelvis.
A venogram allows doctors to identify varicose veins in the pelvis. During this procedure, a catheter is inserted and threaded through the affected vein, and an X-ray dye is injected to highlight the vein. An X ray is then taken. Next, small steel coils are implanted to block blood flow through the abnormal vein. These causes die varicose veins to shrivel and disappear.
Typical cost: $7,000.
Malignancy detection Heiko Schoder, MD
A new technology, known as PET-CT fusion, allows doctors to pinpoint the precise location of cancer cells in the body (for all types of cancer) without having to rely on additional imaging procedures and examinations. The positron emission tomography (PET) locates the small lesions, and the CT scan then precisely pinpoints them.
What’s involved: The patient first undergoes a CT scan, a computer-enhanced X-ray study that produces two-dimensional images. Then the patient undergoes a PET scan. For this test, a radioactive substance that’s called a “tracer” is injected into a vein. The patient next is placed inside a ring-shaped PET scanner, which detects radiation and records sites of high activity, where cancer is likely to be present. The two tests take about one-half hour to perform. Afterward, the radiologist “fuses” the results of a PET scan with the detailed anatomical images of a CT scan.
Typical cost: $2,000 to $4,000 for both.
A study at Memorial Sloan-Kettering Cancer Center found that the use of combined scans improved accuracy by 42% when diagnosing the location of tumors of the head and neck.
Coronary artery disease Sheldon Sheps, MD
A new five-minute, noninvasive imaging test known as an electron beam CT (EBCT) heart scan assesses the amount of calcium in your coronary arteries. Because calcium is a major component of arterial plaque, a high coronary calcium level indicates significant plaque buildup in the blood vessels.
What’s involved: A cardiologist or radiologist uses the recently developed ultrafast-CT scanner that provides detailed pictures of your heart. The procedure exposes the patient to relatively low levels of radiation.
Typical cost: $400.
A heart scan provides a quick and accurate assessment of heart attack risk without the potential risks associated with an angiogram, in which a catheter is used to inject a dye into the heart that can be seen on x rays.