Coronary Artery Calcium Scan Embraced By New AHA/ACC Cholesterol Guidelines: Will Insurance Coverage Follow?

Thank you Dr. Pearson.

The Skeptical Cardiologist

The skeptical cardiologist has been utilizing coronary artery calcium (CAC) scans to help decide which patients are at high risk for heart attacks, and sudden cardiac death for the last decade. As I first described in 2014, (see here) those with higher than expected calcium scores warrant more aggressive treatment and those with lower scores less aggrressive treatment.

Although , as I have discussed previously, CAC is not the “mammography of the heart” it is incredibly helpful in sorting out personalized cardiovascular risk. We use standard risk factors like lipids, smoking, age, gender and diabetes to stratify individuals according to their 10 year risk of atherosclerotic cardiovascular disease (ASCVD) but many apparent low risk individuals (often due to inherited familial risk) drop dead from ASCVD and many apparent high risk individuals don’t need statin therapy.

Previously, major guidelines from organizations like the AHA and the ACC did not recommend…

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NCI Study: MRI of the Prostate Misses Cancers

About 16% of lesions were missed, and approximately 5% of clinically important prostate cancers (>5 mm, Gleason score > 3+3) were underestimated on MP MRI, according to Baris Turkbey, MD, of the Molecular Imaging Program at the National Cancer Institute in Bethesda, Maryland, and colleagues. Overall, prostate cancer size was underestimated by at least 30% in eight (8%) of 100 patients. Their study was published online October 20 in Radiology.

Source: NCI Study: MRI of the Prostate Misses Cancers

Seniors May See Brain Shift from Vessel Ischemia

The bright white spots that show up on brain scans in older people may be a manifestation of disease and not just a benign byproduct of aging, according to a prospective study.

Leukoaraiosis is the radiologic term for nonspecific white matter T2 signal hyperintensities that show up on structural brain MRI. Also known as small vessel ischemia, the bright spots are thought to be the result of microangiopathic damage and their clinical importance has been debated.

via Seniors May See Brain Shift from Vessel Ischemia.