'Super X-Ray' Finds Heart Disease

ORLANDO - A type of "super X-ray" showed promise in its first big test as a potentially cheaper, faster, painless way to determine if certain people with signs of heart disease have it and need treatment.

The scans might eliminate the need for some of the 1.3 million cardiac catheterizations done yearly in the United States to check for clogged arteries, said Julie Miller of Johns Hopkins University.

But the newer scans are controversial. Medicare and private insurers are debating whether to pay for them. Many heart specialists oppose them, partly because they supply a big dose of radiation.

That raises the risk of cancer and might spur thousands of additional cases if the scans were widely used, said Michael Lauer of the National Heart, Lung and Blood Institute. Addressing an American Heart Association conference where study results of the scan were presented Monday, he called on doctors not to use the scans until research proves they save lives.

The new CT scan technology came on the market two years ago and is used by many hospitals. Because it uses 64 detectors to produce and combine images, scans are called "64-slice CT." Images are so detailed that a doctor described them as an almost surgical view.

In the new study, scans were tested against the current method of checking a patient for heart disease: angiograms in a cardiac catheterization lab. A tube is placed in a blood vessel in the groin and maneuvered near the heart. A special dye is infused that makes the arteries show up on X-rays.

Miller's international study was the first direct comparison. It was funded by scanner maker Toshiba Medical Systems. Miller has had research grants from the company.

In the study of 291 people, nine out of 10 patients with blockages were identified by scans, as were 83 percent of those without blockages. The scans ruled out heart disease in half of the patients - those who could have been spared the pain, expense and risk of catheterization, Miller said.

"I don't buy it," said Steven Nissen of the Cleveland Clinic, former American College of Cardiology president. "If you do a CT and you find anything, you've got to do a catheterization anyway."