Radiation levels - 64-slice CT vs. new 'dual-source' CT

[mike e]

Hi, i had an 'abnormal stress test and, with no HD symptoms
I am slated for a CT Angiogram. My doc got approval w/ insurance
for a local '64 slice' scan next week. I'm aware of the radiation issue
and subsequently
learned that there's a hospital in a nearby city that has the new
dual-source CT available...

The latter would be entirely out-of-pocket. However, it's also touted
to be up to 50% lower
radiation dosage for the procedure my Doc needs done. I am trying to
learn what the
actual difference in radiation exposure is between the older 64-slice
vs the dual-source
for this procedure. I'm hoping to find some advice on whether it would
be worth it to opt
for the newer dual-source exam vs. the 64-slice. FYI I am 5'8 and abt.
168 lbs...48 y/o male.

If anyone here can enlighten me on what's known about the different
technologies involved,
I'd greatly appreciate your opinions or referrals to resources that
would help me understand
the radiation differential between these two techhnologies.

Thanks in advance,

Mike in Mich

[Andrew B. Chung, MD/PhD]

The designated radiation safety officer at each hospital should be able
to provide you specific information on the dose of radiation exposure
that is anticipated for their respective machines for the CT angiogram
procedure you would undergo.

> Thanks in advance,

You are welcome.

All thanks and praises belong to GOD, Whom I love with all my heart,
soul, mind, and strength.

May GOD continue to heal our hearts with HIS living water so that we
can love our neighbors a little more and LORD Jesus Christ a lot more,
dear Mike whom I love unconditionally.

Prayerfully in Christ's amazing love,

Andrew <><
--
Andrew B. Chung
Cardiologist, Atlanta, Georgia, USA
http://HeartMDPhD.com/HolySpirit

As for knowing who are the very elect, these you will know by the
unconditional love they have for everyone including their enemies
(Matthew 5:44-45, 1 Corinthians 13:3, James 2:14-17).
http://HeartMDPhD.com/Love

Meanwhile, HIS brethren have been blessed:

http://MabletonGA.OurLittle.net/DreadNought

... and continue to be blessed:

http://MabletonGA.OurLittle.net/Guarantee

(note: Only those who are blessed by LORD GOD Almighty, Creator of
heaven and earth, will have access to these and other related
OurLittle.net articles per a secure IP database maintained by
TheWellnessFoundation.com)

> Mike in Mich

[Jeff]

"Andrew B. Chung, MD/PhD" <lov...@thetruth.com> wrote in message
news:1168047084.5...@42g2000cwt.googlegroups.com...

Mr. Chung is correct.

Different CT machine models might have different radiation levels for the
same test. The radiation safety officer should have the appropriate
information. You can also get the model of the CT machine and research the
issue for the particular machine on the web. I don't know how high the risk
of cancer or other problems is with a particular model of CT scanner.

If you are in the lower peninsula, you may be able to find multiple CT
machines in places like Flint, Grand Rapids, Kalamazoo, Battle Creek, Toledo
OH, Jackson, Lansing, Ann Arbor and the Detroit. If I am not mistaken, the
last three areas all have at least two hospitals that are likely to have CT
scanners and heart programs, and the other areas at least one.

Jeff

<...>

[Joe Doe]

In article <1168043518....@q40g2000cwq.googlegroups.com>,
"mike e" <mike...@gmail.com> wrote:

> If anyone here can enlighten me on what's known about the different
> technologies involved,
> I'd greatly appreciate your opinions or referrals to resources that
> would help me understand
> the radiation differential between these two techhnologies.
>
> Thanks in advance,
>
> Mike in Mich

A good place that has good overview of many of the imaging technologies
is angioplasty.org

See:
http://www.ptca.org/imaging/news/imaging_newscenter.html?http://www.ptca.
org/news/2006/0728.html

http://www.ptca.org/imaging/news/imaging_newscenter.html?http://www.ptca.
org/news/2006/0509.html

and
http://www.ptca.org/nv/forum.html?/forumtopics/topic_CT_angiogram.html

The dual source is definitely better technology advantages summarized
here:

http://www.diagnosticimaging.com/cardiovascular/feature/showArticle.jhtml
?articleID=193101341

The radiation risk from all these procedures is real but small,
typically these procedures are in the equivalent of 100 or so chest
x-rays (ballpark). The quantification of excess cancer risk is in one
of the links I posted above. If you do this very often it begins to add
up (if you need to do it of course you have no choice i.e. radiation
exposure may cause a problem down the road but no intervention may hurt
you now.)

The last question is whether you are likely to need a catherization
anyway what is the better test? This is addressed among some of the
forum questions in another of the links I posted above. You might want
to consider all this and discus with your physician what is the best
approach for you.

Roland

[Andrew B. Chung, MD/PhD]

Convicted neighbor Jeff wrote:

All praises and glory belongs to GOD, Whom I love with all my heart,
soul, mind, and strength:

http://HeartMDPhD.com/HolySpirit/fear.asp

Fear GOD and dread nothing (especially not demons) that is of this
world:

http://MabletonGA.OurLittle.net/DreadNought

Clearly you remain convicted by the Holy Spirit:

http://HeartMDPhD.com/Convicts

May you choose wisely at this crossroads in your life:

http://groups.google.com/group/sci.med.cardiology/msg/fcb058da12bb3f3d?

"You do not have much longer to live." -- Holy Spirit

Amen.

May GOD continue to heal our hearts with HIS living water curing our
diabetes, depression, anxiety, or panic so that we can love our
neighbors a little more and LORD Jesus Christ a lot more, dear neighbor
Jeff whom I love unconditionally.

[mike e]

Thanks for the insights. In reply to Jeff, I am basically in a
position to choose between the two types... (Detroit-Toledo area) and
it comes down to whether i want to do the '64' one locally, and
would be covered by insurance....OR, could also go to Beaumont in
Detroit for the new Dual-Source
CT, which is not covered by insurance, is purported to have
significantly less radiation than the
64 slice - and out-of-pocket, would cost 750.00. Either is okay by my
doctor...I need to figure out
whether the reduced exposure - if that is so - is worth forgoing the
insurance covered version and
paying for myself.

I have what's been characterized as a mild wall abnormality in the area
where the diaphragm
is obscuring a clear view on the echo-gram and stress tests - hence the
next step recommended
by my GP was the CT - He felt i was a good candidate for this since I
do not have symptoms,
did about 10 min. on the ST, feel great and have normal cholesterol,
weight, and was running
15-20 mi. a week until December.

Thanx,

Mike

[Andrew B. Chung, MD/PhD]

The diaphragm typically does not obscure clear views on an
echocardiogram nor does it typically impact the EKG portion of the
stress test.

[mike e]

> The diaphragm typically does not obscure clear views on an
> echocardiogram nor does it typically impact the EKG portion of the
> stress test.

Okay, I may be miscommunicating his evaluation but for some
reason, he wants/needs the CT.

Thanks,

Mike

[Andrew B. Chung, MD/PhD]

It would be wise for you to have a clear understanding about the
indications for the testing prior to your subjecting yourself to the
radiation and contrast exposure.

> Thanks,

You are welcome, Mike :-)

[mike e]

> It would be wise for you to have a clear understanding about the
> indications for the testing prior to your subjecting yourself to the
> radiation and contrast exposure.
>

OK, my understanding is that there is an area in question which the
Dr. needs to see, in order to asess this, and provide an accurate
diagnosis.

The Dr. advised that a CT would provide this view which the echo and
stress test did not reveal. He thus recommended the 64 scan.

[Andrew B. Chung, MD/PhD]

If you are not prepared for either angioplasty or bypass surgery to
"treat" any atherosclerotic lesions they may find on CT, it would not
be wise to subject yourself to the potentially hazardous radiation and
IV contrast associated with the test.

[mike e]

> If you are not prepared for either angioplasty or bypass surgery to
> "treat" any atherosclerotic lesions they may find on CT, it would not
> be wise to subject yourself to the potentially hazardous radiation and
> IV contrast associated with the test.

Well, assuming that I am in need of some conclusive diagnosis to
clarify
what if any further need for 'treatment' there may be, I guess I'm
still searching
for a definitive answer to the question, is the "dual-source" CT that's
available,
a better alternative than the "64 slice" CT, with regard to the
radiation issue.

Thanks again,

Mike

[Andrew B. Chung, MD/PhD]

The risks may be unacceptably high for either if the benefit is zero.

> Thanks again,
>
> Mike

[James...@yahoo.com]

Lets put the radiation risk in perspective. A chest x-ray today
exposes you to about the radiation then you would get on a cross
country airplane flight at 35000 feet. That high and you get a tiny
amount of radiation from cosmic rays that is screened out at the
surface by the atmosphere. Many people fly at this altitude across the
country 100 times per year for many years and none of them worry at all
about getting cancer from this tiny amount of radiation.

Your concern about the amount of radiation is a valid concern in the
absence of any understanding. Why expose yourself if it is not
important? On the other hand the risk is so tiny that there is so
close to zero chance of any health problem the reward far out weighs
the tiny risk. After all they will see things besides your heart and
you may even solve some health issue you did not know exists. The big
risk you are running is getting into a traffic accident and getting
killed on the way to the test or on your way home from the test. Of
course you can avoid this risk by never getting in a car again.

[Joe Doe]

In article <1168132252.6...@q40g2000cwq.googlegroups.com>,
James...@yahoo.com wrote:

> Your concern about the amount of radiation is a valid concern in the
> absence of any understanding. Why expose yourself if it is not
> important? On the other hand the risk is so tiny that there is so
> close to zero chance of any health problem the reward far out weighs
> the tiny risk. After all they will see things besides your heart and
> you may even solve some health issue you did not know exists. The big
> risk you are running is getting into a traffic accident and getting
> killed on the way to the test or on your way home from the test. Of
> course you can avoid this risk by never getting in a car again.

The risk was quantified as 7 excess cancer deaths per 10,000 people over
a lifetime from a multi slice CT procedure in one of the links I
provided. I agree this is a small risk. Exposing yourself to a spate
of such procedures however may not make sense. I.e if he has a CT then
has a cath he is doubling his exposure. So the question is he really a
candidate for the CT or a cath based on what his stress test revealed.

Roland

[Andrew B. Chung, MD/PhD]

There is also the risk of IV contrast in both procedures.

http://groups.google.com/group/sci.med.cardiology/msg/ec56c2a8d82c903a?

May GOD continue to heal our hearts with HIS living water so that we

can love our neighbors a little more and LORD Jesus Christ a lot more,

dear Roland whom I love unconditionally.

[mike e]

>
> The risk was quantified as 7 excess cancer deaths per 10,000 people over
> a lifetime from a multi slice CT procedure in one of the links I
> provided. I agree this is a small risk. Exposing yourself to a spate
> of such procedures however may not make sense. I.e if he has a CT then
> has a cath he is doubling his exposure. So the question is he really a
> candidate for the CT or a cath based on what his stress test revealed.
>
> Roland

Thanks for the specific information regarding actual radiation dosage.

To address the question about being a candidate for the CT vs. a cath,
in my physician's opinion, given the predominantly good ST results, and

overall excellent health, lack of symptoms, athletic lifestyle, normal
cholesterol,
good low fat diet and normal weight...my Dr. is not strongly inclined
to believe,
nor am I, that I need invasive procedure that is, in effect,
exploratory, when
a non-invasive CT is available. Given the condition as characterized;
a mild wall abnormality reported in an area that the diaphragm- for
reasons
i cannot precisely re-state - is "involved" as a factor that prevents
the Dr.
from a conclusive asessment - he advised the locally-available CT,
which
is the 64 variety. Subsequently learning of the availability of the
newer
dual-source, I studied it and one of the points simply presented in the
hospital's
claims, was that of a reduced radiation exposure compared with other
types of
CT like the 64-slice.

That said, I guess it's a matter of weighing the known risk - which I
appreciate
your appraisal of - involving either one type of CT or the other....

Thanks,

Mike

[Andrew B. Chung, MD/PhD]

mike e wrote:
> >
> > The risk was quantified as 7 excess cancer deaths per 10,000 people over
> > a lifetime from a multi slice CT procedure in one of the links I
> > provided. I agree this is a small risk. Exposing yourself to a spate
> > of such procedures however may not make sense. I.e if he has a CT then
> > has a cath he is doubling his exposure. So the question is he really a
> > candidate for the CT or a cath based on what his stress test revealed.
> >
> > Roland
>
> Thanks for the specific information regarding actual radiation dosage.

There are other problems besides cancer that could arise from increased
radiation exposure.

> To address the question about being a candidate for the CT vs. a cath,
> in my physician's opinion, given the predominantly good ST results, and
> overall excellent health, lack of symptoms, athletic lifestyle, normal
> cholesterol,
> good low fat diet and normal weight...my Dr. is not strongly inclined
> to believe,
> nor am I, that I need invasive procedure that is, in effect,
> exploratory, when
> a non-invasive CT is available.

Because of exposure to a clinically significant dose of radiation and
IV contrast, CT is not truly non-invasive.

> Given the condition as characterized;
> a mild wall abnormality reported in an area that the diaphragm- for
> reasons
> i cannot precisely re-state - is "involved" as a factor that prevents
> the Dr.
> from a conclusive asessment - he advised the locally-available CT,
> which
> is the 64 variety.

If the question is whether you have a mild wall motion abnormality at
the inferior wall of your left ventricle is the question, this will not
be answered by the CT.

May GOD continue to heal our hearts with HIS living water so that we

can love our neighbors a little more and LORD Jesus Christ a whole lot
more, dear Mike whom I love unconditionally.

[James...@yahoo.com]

I will accept the 7 excess cancer deaths per 100.000 people over a
lifetime as the official published number. Yet this number is very
misleading. The OP is 48. Thus he has already used about 5/8 of his
lifetime. So the first correction that needs to be made is to correct
for remaining lifetime. This gets it down to about 3 per 100,000.

Next you must consider latency in cancer development. Latency is very,
very important as radiation induced cancers increase with time from
exposure in way more then a linear fashion. As the OP does not have
anyplace close to a full lifetime after exposure you need to adjust
that 3/100,00 down substantially to account for latency.

Then you need to consider how the 7/100,000 was derived to start with.
It was derived by dosing at a very high dose and assuming the dose
response curve is linear. Of course it is very well documented that
the dose reponse curve for radiation induced cancer is not linear.
Rather it has a substantial upwards concavity when you plot dose on the
vertical axis and life time response rate on the horizontal axis. This
dictates the rational person should make an added downward adjustment
to the actual risk estimate. By the way, a linear response is how
virtually all tox data is treated so there is nothing unusual about
this case. And a linear response is known to always be incorrect. But
it is simply too expensive to get the actual data on the shape of the
curve so this highly conservative data treatment is what is standard.

When you make reasonable corrections to the data for the known factors
that make the 7/100,000 incorrect you come up with a real estimated
risk for the OP of no more then 1/100,000 and likely quite a bit lower.

The big risk is not the radiation. The big risk is driving to the
medical center for the test.

[mike e]

Andrew B. Chung, MD/PhD wrote:
> mike e wrote:
> > >
> > > The risk was quantified as 7 excess cancer deaths per 10,000 people over
> > > a lifetime from a multi slice CT procedure in one of the links I
> > > provided. I agree this is a small risk. Exposing yourself to a spate
> > > of such procedures however may not make sense. I.e if he has a CT then
> > > has a cath he is doubling his exposure. So the question is he really a
> > > candidate for the CT or a cath based on what his stress test revealed.
> > >
> > > Roland
> >
> > Thanks for the specific information regarding actual radiation dosage.
>
> There are other problems besides cancer that could arise from increased
> radiation exposure.

Thank you for the cold hard truth. I feel much better now ; )

[Andrew B. Chung, MD/PhD]

mike e wrote:

You are welcome.

All thanks, praises and glory belong to my heavenly Father, Whom I love
with all my heart, soul, mind, and strength.

HE led me here to be that uncovered lamp on this hill in the darkness
known as usenet.

> for the cold hard truth.

The truth, Who is LORD Jesus Christ, is neither cold nor hard.

"I am the way, the truth, and the life... " -- LORD Jesus Christ

Amen.

> I feel much better now ; )

If the transthoracic echocardiogram is redone by the cardiologist
himself/herself instead of by an echo tech, it is possible that the
question about your possibly having an inferior wall motion abnormality
can be answered truly non-invasively. Other alternatives would include
TEE, gated SPECT, and MUGA. However, these are more invasive.

May GOD continue to heal our hearts with HIS living water so that we

can love our neighbors a little more and LORD Jesus Christ a lot more.

[mike e]

>Andrew B. Chung, MD/PhD wrote:

If the transthoracic echocardiogram is redone by the cardiologist
himself/herself instead of by an echo tech, it is possible that the
question about your possibly having an inferior wall motion abnormality
can be answered truly non-invasively. <

I don't understand. After the echo, a stress test was ordered which was
reviewed by at least one Cardiologist. According to the GP, their
analysis was that some positivity was evident, and thus supported
the initial indication of the echo..gram.

It was my understanding the the ST IS the gold standard precursor
testing before angio procedure including further diagnostic imaging.

As such, hasn't a cardiologist technically already been involved.

Mike

[Andrew B. Chung, MD/PhD]

mike e wrote:
> Andrew, in the Holy Spirit, boldly wrote:
>
> > If the transthoracic echocardiogram is redone by the cardiologist
> > himself/herself instead of by an echo tech, it is possible that the
> > question about your possibly having an inferior wall motion abnormality
> > can be answered truly non-invasively.
>
> I don't understand.

For identifying regional wall motion abnormalities, an echocardiogram
is closer to being the gold standard than the stress test.

> After the echo, a stress test was ordered which was
> reviewed by at least one Cardiologist. According to the GP, their
> analysis was that some positivity was evident, and thus supported
> the initial indication of the echo..gram.

If the echocardiogram justified the stress test, then the inferior wall
motion abnormality is certain and you have had injury to that part of
your heart.

> It was my understanding the the ST IS the gold standard precursor
> testing before angio procedure including further diagnostic imaging.

Not for the question about an inferior wall motion abnormality.

> As such, hasn't a cardiologist technically already been involved.

Not to the extent that may be necessary if the question being asked is
whether you have an inferior wall motion abnormality which would not be
answered by CT angiography but would be answered by ventriculography
during invasive heart catherterization.

In the Holy Spirit,

Andrew <><
--
Andrew B. Chung, MD/PhD
http://EmoryCardiology.com

[mike e]

James, thanks for your perspective. I do appreciate your opinion.

As for the actual equipment involved, the diverse answers about the
technology that's out there have been interesting albeit confusing.

When I called the hospital with the "dual-source" CT machines this
morning to ask about the difference between this version and the
"64-slice" CT, the Heart Center physician I spoke with
advised me that between the two, the radiation exposure is "about the
same."

Of course, this contradicts manufacturer information that suggests "up
to 50% lower" exposure
due to the different technology which is touted as an advantage of the
dual-source procedure.

I am now even more confounded in seeking an answer to what was really
my initial question which
was simply,
What's the difference in radiation between these two procedures?

Thanks again,

Mike

PS - I am holding off on what was a 15-20 mile a week running routine
while I wait for this to
be sorted out. Would it not be prudent to resume at least some regular
cardio exercise. Again,
no symptoms, normal cholesterol good BMI/weight and a non-fat
no-choleseterol diet. I know
the efforts to draw me into "The System" tend to deter people from
thinking they should continue
their active lifestyle but I am not buying it at this point based on
the circumstances I've described
earlier. This experience thus far has just reinforced how much
patients need to do their homework and, reinforced my commitment to an
already heart-healthy diet and good lifestyle habits I have maintained
for years... Exercise is of course a key part of that equation.

most of my recent years...and

[Andrew B. Chung, MD/PhD]

mike e wrote:
> James, thanks for your perspective. I do appreciate your opinion.
>
> As for the actual equipment involved, the diverse answers about the
> technology that's out there have been interesting albeit confusing.
>
> When I called the hospital with the "dual-source" CT machines this
> morning to ask about the difference between this version and the
> "64-slice" CT, the Heart Center physician I spoke with
> advised me that between the two, the radiation exposure is "about the
> same."
>
> Of course, this contradicts manufacturer information that suggests "up
> to 50% lower" exposure
> due to the different technology which is touted as an advantage of the
> dual-source procedure.
>
> I am now even more confounded in seeking an answer to what was really
> my initial question which
> was simply,
> What's the difference in radiation between these two procedures?

It looks like you have the answer that they are about the same.

> Thanks again,
>
> Mike
>
> PS - I am holding off on what was a 15-20 mile a week running routine
> while I wait for this to
> be sorted out. Would it not be prudent to resume at least some regular
> cardio exercise. Again,
> no symptoms, normal cholesterol good BMI/weight and a non-fat
> no-choleseterol diet. I know
> the efforts to draw me into "The System" tend to deter people from
> thinking they should continue
> their active lifestyle but I am not buying it at this point based on
> the circumstances I've described
> earlier. This experience thus far has just reinforced how much
> patients need to do their homework and, reinforced my commitment to an
> already heart-healthy diet and good lifestyle habits I have maintained
> for years... Exercise is of course a key part of that equation.

Actually if you are having silent ischemia, it would not be wise to
engage in strenuous exercise until that resolves one way or another.

[James...@yahoo.com]

mike e wrote:
> James, thanks for your perspective. I do appreciate your opinion.
>
> As for the actual equipment involved, the diverse answers about the
> technology that's out there have been interesting albeit confusing.
>
> When I called the hospital with the "dual-source" CT machines this
> morning to ask about the difference between this version and the
> "64-slice" CT, the Heart Center physician I spoke with
> advised me that between the two, the radiation exposure is "about the
> same."
>
> Of course, this contradicts manufacturer information that suggests "up
> to 50% lower" exposure
> due to the different technology which is touted as an advantage of the
> dual-source procedure.
>
> I am now even more confounded in seeking an answer to what was really
> my initial question which
> was simply,
> What's the difference in radiation between these two procedures?
>
> Thanks again,
>
> Mike
>

Mike,

What the doctor is saying is the level of radiation is so low that
there is no meaningful risk difference between the two methods. What
the equipment manufacturer is saying is advertisement and marketing
hype. Both are correct for different reasons. If I needed to undergo
the procedure I would simply follow my personal doctors suggestion.
You need to decide what makes you comfortable and science is not
necessarily the answer. For you the marketing stuff may be more
important.

Ask your doctor if it is ok to run. If he says yes go ahead. If he
says no I think it best to follow his advice. I sure would not follow
any advice from the internet on running or not running. No one here
has enough knowledge of your personal situation to make any rational
judgement. I would say that if your doctor says no and you run anyhow
you are accepting vastly more risk then you face from the minor
radiation exposure.

[Andrew B. Chung, MD/PhD]

James...@yahoo.com wrote:
> mike e wrote:
> > James, thanks for your perspective. I do appreciate your opinion.
> >
> > As for the actual equipment involved, the diverse answers about the
> > technology that's out there have been interesting albeit confusing.
> >
> > When I called the hospital with the "dual-source" CT machines this
> > morning to ask about the difference between this version and the
> > "64-slice" CT, the Heart Center physician I spoke with
> > advised me that between the two, the radiation exposure is "about the
> > same."
> >
> > Of course, this contradicts manufacturer information that suggests "up
> > to 50% lower" exposure
> > due to the different technology which is touted as an advantage of the
> > dual-source procedure.
> >
> > I am now even more confounded in seeking an answer to what was really
> > my initial question which
> > was simply,
> > What's the difference in radiation between these two procedures?
> >
> > Thanks again,
> >
> > Mike
> >
>
> Mike,
>
> What the doctor is saying is the level of radiation is so low that
> there is no meaningful risk difference between the two methods.

No that is not what the doctor is saying:

http://groups.google.com/group/sci.med.cardiology/msg/22d15c84c8aece37?

In the Holy Spirit,

Andrew <><
---

[mike e]

> No that is not what the doctor is saying:
>

Ooookay then, as I fast approach Friday, the date upon which I am
scheduled for the 64 slice
test, and having come to a conclusion that there is essentially about
the same exposure level
between the "dual-core" and 64-slice CT, what pray tell would you,
yourself do in my case, if
you need to have this done? I am appreciative of those who take the
time to offer insights here,
but the degree of uncertainty generated by the varied responses leads
one to find it difficult
to draw conclusion. Bottom line...am I or am I NOT at risk for higher
radiation dosage from
a "dual-core" procedure than that of the 64-slice machine? Frankly,
there is enough vacilation
on the part of the so-called experts whom I've spoken to at hospitals
to leave me uncertain
about their own knowledge, let alone the mixed information and
implications of doubt presented
on this forum.

With all due respect,

Mike

PS: helpfulness to me, is largely CLARITY.

[mike e]

correction: "Dual Source" CT"

[Po...@nospam.invalid]

"mike e" wrote:
>what pray tell would you, yourself do in my case, if you need to have this done?

-raises hand-
Can anybody answer?
If it were me, after reading the thread and looking at a few websites,
my uneducated opinion would tilt toward 64 slice for two reasons.
1. Your doctor suggested it.
2. Your insurance will cover it
3. Seems difference in radiation isn't enough to matter (even worse
case, half of not much isn't much).

(ok, three reasons.... and I could prolly think of more).

Now. If I had money to burn, I'd go the 'dual source' route just to
watch that sucker work :-)

Port
.... and by the way, whichever one you try, don't forget to report
back here with what you think of its pictures, k?

[mike e]

Thank you very much for your opinion.

I appreciate your reasoning and will be glad to post info abt. my
experience.

Best Regards,

Mike

[Andrew B. Chung, MD/PhD]

If you were my patient, I would personally redo the resting
transthoracic echocardiogram if there is any uncertainty about the
inferior wall motion abnormality. If the inferior wall motion
abnormality is certain, I would look at the resting EKG to determine
whether there is any active ongoing ischemia or if the inferior wall is
infarcted. The latter would also compell me to look more closely at
your inferior wall for the thinning and calcification that
characterizes scarring of post-infarction heart muscle. Any lingering
uncertainty would be easily resolved with stress echocardiography.
This approach is completely non-invasive without either IV contrast or
radiation exposure.

In the Holy Spirit,

Andrew <><
--

[Art Deco]

False prophet Andrew B. Chung spammed:

Fortunately for him you aren't his doctor, Chung.