EBT Calcium Scan

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Tincup
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Re: EBT Calcium Scan

Post by Tincup »

Russ,

I will. i wonder if he knows about Raggi: http://atvb.ahajournals.org/content/24/ ... l.pdf+html
Specifically, from the paper Fig 2 & 3 (you can click each one separately to zoom).
Screen Shot 2015-05-10 at 3.39.33 PM.png
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Russ
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Re: EBT Calcium Scan

Post by Russ »

George,

Boy, that Figure 3 sure looks pretty solid! Makes it very clear that total calcium score is irrelevant if progression is less than 15% per year - even up into the CAC > 1000. I am most surprised that the paper is from 2004 and yet I don't recall anyone referencing before?

Would love to hear any counter arguments from anyone as this looks very solid.
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Re: EBT Calcium Scan

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In the Q&A after the movie screening, Dr. Blanchet said he does tighten the 15% target for those with scores > 1000. He'd like 3-6% for those people. On the CD's, he says (at the time of recording) he had >90 patients with score > 1,000, including one >9,000. No heart attacks in 6 years of treating them. Said the 9,000 guy is still very active, trekking across Alaska. He also said he had > 900 (from my memory) patients with high, but <1000 scores. They are all doing fine. The CD mp3's are worth listening to.
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Re: EBT Calcium Scan

Post by Matisse »

GeorgeN wrote:
Matisse wrote:May I ask who he is and where he is (w/o downloading)? Thanks.
Phone: 303-443-7226
Fax: 303-443-7168
William L. Blanchet, MD
2880 Folsom, Suite 100
Boulder, Colorado 80304

The link to his website is in my post above .
Thank you George.
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Re: EBT Calcium Scan

Post by MarcR »

George, thank you very much for bringing this information to my attention. Listening to the CDs was well worth my time. Dr. Blanchet makes a lot of sense to me. I especially appreciate his clear explanations of the CVD process and why annual progression is so much more predictive than absolute score. Until today I had been unmotivated to get this test; now I am going to make it a priority.

It seems to be a four-figure expense where I live, so the savings from visiting FRPI for this test for me and my wife will pay for our travel expenses to beautiful Boulder. :-)
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Re: EBT Calcium Scan

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Hey merouleau,

I checked and I think there are several EBT's in the Bay Area. You might check on cost & location and get it done while you're there, if you have time...

If you come to our area, you certainly have a place to stay, if you want it.
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Re: EBT Calcium Scan

Post by MarcR »

Great suggestion, George, and thanks also for the offer to host us - very kind!

I did some more poking around. As I understand it now, there are two ways to get a CAC score:

1. Electron Beam Computed Tomography (EBCT or just EBT). This is the device used in the research studies which established the predictive power of CAC score tracking. The manufacturer was bought by GE in 2001. Since that time, the industry has moved to the more versatile 64-MDCT technology, and GE no longer sells EBCT devices.

2. 64 Slice Multidetector Computed Tomography (64-MDCT). Because this device provides a superset of EBCT functionality, it has become the scanner of choice for radiology practices. It seems to read about 20% lower than EBCT.

I didn't find many well-equipped radiology labs that are happy to do business directly. Most of them seem to require referrals. I couldn't identify such a lab in Portland, OR or Vancouver, WA (near my home), but I did locate one in Bend, OR, about three hours away. It offers 64-MDCT CAC scores for $99.

Since much of the diagnostic value seems to be in measuring the rate of progression over time, I lean toward starting my results series with 64-MDCT since it seems likely to be around longer.

Incidentally, this article tells me that EBCT precision is close to Dr. Blanchet's 15% safe annual progression threshold overall and much much worse at lower non-zero CAC scores, and this article tells me that 64-MDCT offers similar precision. I wonder if Dr. Blanchet's 15% guideline is just a practical way of saying 0% while allowing for device imprecision. Also, given the precision findings, it's pretty clear that a 300% increase from 2 to 8 is NOT the same as a 300% increase from 200 to 800.
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Re: EBT Calcium Scan

Post by Tincup »

Yes, I concur. One reason I like the EBT better is the lower radiation exposure. The 64-MDCT is a better choice from a revenue standpoint for the medical provider because of its flexibility.
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Re: EBT Calcium Scan

Post by Julie G »

I'm resurrecting this thread as I was just just about to toss a hard copy of this 2015 Medscape article I got during our recent meet-up and thought I ought to share for those who weren't there. (You may have to register to see it. It's free & simple.)

Just in case you thought your low Framingham Risk Score (FRS) put you in the clear; think again...
Overall, the addition of the CAC score to the FRS reclassified risk in 50.7% of individuals...
That's HUGE; over half of patients in this study with low Framingham Risk Scores (that's most of us) we're actually found to be at a greater risk of CVD per CAC scoring. Every other cardiac test is a surrogate marker. This is the only one that demonstrates real risk assesment.

Coronary Calcium Imaging Improves on Framingham Score Regardless of Symptoms in Analysis
http://www.medscape.com/viewarticle/839562
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Re: EBT Calcium Scan

Post by Hubbs »

OHSU and Oregon Imaging Centers both use "iDose" to minimize radiation. Perhaps its safe enough?
http://clinical.netforum.healthcare.phi ... izing-dose

I had my very first consultation with a cardiologist regarding CVD prevention and he asked me to start treatment with Statin right away because my LDL-P is too high (May/2080, Sept/1970, Dec/1817). I mentioned that my CT calcium scoring was zero in 2012 and requested to repeat the scan before taking the med. Somewhere I read that if calcium score does not change in 2.5 years then things are not developing and no need for statin. But how reliable these tests are to predict risk, experts seems disagree with one another.

The doctor said that no amount of diet change and exercise could bring my LDL-P down under 1000 due to genetics. Is that true? With helpful information from Stavia and George, I easily shifted into eating within 8 hours/day. Also increased exercise and eat sauerkraut. My newer # looks a little better so I still hope that somehow I can get myself out of high risk category without committing to a long term medication. Or wishful thinking for a apoe3/4 with family history of CVD?
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