Total Body Scans: The Glass Body In 40 Seconds / ECR 2007

Less than ten years ago it took several hours to complete a scan on a patient with computer or magnetic resonance tomography. That was an unreasonably long scan time and in the case of CT, also entailed extremely high exposure to radiation. Today, MRT scanners image with up to 72 coils at the same time; CT units scan 64 slices at a time and in lab tests as many as 256. The rotors that move the imaging units around the patient to produce the slice images now have much greater rates of acceleration. An increasing number of MRT units operate today with parallel imaging and have a field strength of 3 Tesla instead of the customary previous strength of 1.5 Tesla. This means more sharply focused images in less time. The problem of venous overlay, i.e. veins overlying the arteries in the image, has also practically been solved.


Precise images taken in an ultra-short time allow for whole body screenings to be performed if disease is suspected.


As a result, today it takes a treating physician just 40 seconds to render the inner workings of an entire human body visible in a total body scan (TBS), in images that are more sharply focused and detailed than ever before. TBS is one of the central topics being discussed at the European Congress of Radiology (ECR 2007), an event held in Vienna (at Austria Center Vienna) from March 9 to 13, 2007, and attended by some 16,000 participants from 92 countries.


As University Professor Dr. Maximilian Reiser, director of the Institute for Clinical Radiology at the Ludwig-Maximilian University in Munich explained, "TBS has led to a complete change in paradigm in diagnostics. Previously, we doctors had to define our area of inquiry precisely in advance, for example, pain in the upper abdomen. Today, if we have any suspicions, we can check the entire body in an ultra-short time. That is a quantum leap forward, especially for systemic diseases whose effects can appear throughout the body."


"This advance has a variety of different applications, from life-saving uses to others whose value we should question," Professor Reiser added. The most important of these applications were presented at the European Congress of Radiology (ECR) 2007 in Vienna.


Polytrauma: After serious accidents in which several organ systems are, or at least might be, injured at the same time, a single examination shows bone fractures, spine injuries, cerebral haemorrhaging, puncturing of the lung, a pneumothorax, haemorrhaging in the pericardium or ruptures and haemorrhaging of inner organs. In short, everything that can quickly lead to death if not detected. Professor Reiser stated, "TBS increases not only a patient's survival rate but his quality of life. After all, complete rehabilitation often depends on correctly detecting injuries and beginning treatment within the first hour after the trauma."


Cancer Diagnosis: TBS makes it possible for the first time to detect any formations of metastases wherever they occur, making it an indispensable tool, especially in follow-up treatment to chemo- and radiation therapy.















Magnetic Resonance Angiography: In the event of arteriosclerosis, MRA enables the entire vascular system, including the heart, to be assessed, and thus the risk of stroke and cardiac infarction to be determined. It also brings to light infarctions that had previously gone undetected.


Psoriatic arthritis and other rheumatic diseases of the joints can be detected and completely diagnosed early on with TBS. Foci of inflammation can be detected even before the patient complains of them. Effective treatments, for example, with TNF inhibitors, can be started early in order to spare patients suffering and costs.


Virtual Autopsy: A growing number of people are refusing to approve an autopsy on family members, thus threatening the medical community with the loss of what is ultimately an important instrument for quality assurance. In combination with ultra-sound guided biopsies of key organs, a complete CT and MR scan of a corpse delivers information of a precision similar to a regular autopsy and of even greater precision when it comes to changes in bone marrow and connective tissue.


Nonetheless, just because a procedure is possible does not necessarily mean it is always sensible. Professor Reiser explained, "The prevailing view in the United States is that a whole-body MRA is indicated for anyone who can afford it. That implies high costs and simply invites the commercial exploitation of fear. I am not in favour of wholesale screenings, but I do advocate the examination of people with certain risk profiles, such as a genetic affliction or diabetes. We have taken this approach in Munich and used TBS to detect a significantly large number of vasoconstrictions in vessels supplying the brain and in leg arteries, which allowed us to treat them, I hope, in time."


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