Total Body CT Scans: Evaluating Their Appropriateness and Utility

Total Body CT (TBCT) scanning is a powerful diagnostic tool offered by the Age Management Center. It is capable of detecting diseases early, often before symptoms manifest. But despite its potentially life-saving benefits, the use of TBCT scans for screening asymptomatic individuals is a topic of debate.

Our goal has always been to help clients be better informed about their health and wellness as well as the treatments and solutions available to them. So to help our clients better understand this particular debate, I’d like to break down when TBCT scans are likely appropriate and when—and why—caution can be advised, so that you have a transparent and balanced perspective on their use.

When Total Body CT Scans are likely appropriate

• Early Detection of Serious Diseases
  TBCT scans are particularly valuable for detecting cancers that typically go unnoticed until they are in advanced stages, such as pancreatic, ovarian, kidney, and aggressive lung cancers. For individuals with a strong genetic predisposition to these diseases, early detection can be life-saving. Dr. Harvey Eisenberg, who has served at both UCLA and Harvard medical schools as a professor of radiologic sciences, and whose company MultiDimensional Imaging introduced the CT Screening BodyScan, emphasizes its role in diagnosing cancer years before symptoms appear, thus offering the best chance for effective treatment and improved survival rates. “Usually we are asymptomatic for years; we’ve got to stop thinking about downstream, crisis-oriented medicine. Cancer may start five to seven years before a symptom.”
• Cardiovascular Health Assessment
  Another critical use of TBCT is in assessing cardiovascular health through what’s called the Cardiac Calcium Score. This test measures the amount of calcium in the coronary arteries, helping to identify atherosclerosis (coronary artery disease) which could lead to heart attacks. The Cleveland Clinic highlights that the Cardiac Calcium Score is particularly useful for individuals with an intermediate risk of heart disease, in other words, those that aren’t at obvious high or low risk. This is to guide preventative measures and potentially prevent severe, unforseen cardiac events.

When Total Body CT Scans may be less appropriate

• The Question of Radiation
  One of the primary concerns with TBCT scanning is the exposure to radiation. So, let’s look at this further, including in comparison to background radiation.

  Background radiation is the kind of radiation you’d get in everyday life, that’s present naturally in our environment (and yes that varies widely depending on your environment and what part of the world you are in).

  A single TBCT scan can expose a person to about 13 millisieverts (mSv) of radiation, which some say is equivalent to four years of natural background radiation; a PET/CT scan, in comparison, exposes someone to approximately 25 mSv of radiation (or 8 years of background radiation). According to the American Cancer Society, “The average American is exposed to about 3 mSv of radiation from natural sources over the course of a year.”

  While experts agree that the risk of cancer from a single scan is low, the cumulative risk from repeated scans needs careful consideration. The American Cancer Society notes that while the increase in cancer risk from imaging tests is likely small, the precise risk is difficult to quantify.

• Financial Implications and Insurance Coverage
  TBCT scans are generally not covered by insurance when used as screening tools for asymptomatic individuals. The financial burden falls on the patient. And if initial scans reveal suspicious findings, follow-up diagnostic scans, typically covered by insurance, can drive up healthcare costs and premiums. This potential for healthcare expenses can be a concern for patients.
• Professional Guidelines and Recommendations
  Leading health authorities, including the Food and Drug Administration (FDA) and other expert groups, advise against the self-referral of asymptomatic individuals for TBCT scans, arguing that the risks associated with false positives, i.e. potentially unnecessary follow-up tests and treatments, can outweigh the potential benefits.

  Their argument is for a more judicious use of TBCT, AKA in cases where there is a clear clinical indication. This is why, at Age Management Center, we require a physician consultation before any recommendation of Total Body CT scan services.

What are you supposed to make of all this?

There are specific scenarios where I believe TBCT scans using the newer CT scanners are highly beneficial, particularly for early detection of certain cancers and cardiovascular diseases in individuals with significant risk factors. However, the above listed concerns aren’t something we can ignore. It is crucial to weigh the risks and benefits on a case-by-case basis, as we do at the Age Management Center. And as technology advances and radiation doses decrease, TBCT scanning may become a more broadly applicable option. Ultimately, the decision to undergo TBCT should be made in consultation with healthcare providers, considering individual risk factors and health goals.

Clearly, there are some diseases, especially cancers like pancreatic, ovarian, kidney, and aggressive lung types, where by the time they become symptomatic and diagnosed, it’s usually too late. This may be especially true when there is a strong genetic history. And yes, there are false positives that may warrant more intense evaluation. But aside from the insurance costs, I personally fail to see how that’s a bad thing!

Finally, my thoughts on the topic of radiation exposure. All the experts agree that the exposure for a single CT on the newer CT scanners is low, and repeated procedures using any form of radiation should be weighed regarding the risk vs. reward. Our CT scan operator partners have discovered several conditions using TBCT that indeed required follow-up treatment, including a kidney cancer requiring surgery, various others cancer cases, and significant cardiovascular disease presence, including the coronary arteries. The equipment gets better every year, the amount of radiation continues to decrease, and risks lessen.

Still, this is a decision everyone needs to make for themselves.

For me, it is a test I happily took myself.