Wednesday, December 29, 2004

Obese and Opaque

Filed under: Society

Think about it: difficult terrain makes an exploration difficult. So there are no surprizes here:

Radiologists have their own term for inconclusive tests due to obesity: "limited by body habitus" abbreviated as LBBH. (Habitus refers to body build.) Too much fat, they say, makes it difficult or impossible to tell whether a patient has a kidney obstruction, to distinguish a benign fibroid tumor from ovarian cancer or to see whether a fetal heart is developing properly.

"There's a lot of attention paid to the health effects of being obese, but what the general public doesn't understand is how much it makes proper diagnosis difficult," said Levon N. Nazarian, professor of radiology at Thomas Jefferson University Hospital in Philadelphia. "Every stage of an obese person's medical care is compromised because of their size, and that includes diagnosis and treatment."

And the manufacturer's response?

Medical device companies say they are doing just that to cope with the projected tsunami of obese patients in the next decade. By 2010, if present trends continue, 50 percent of Americans could be classified as obese.

Siemens Medical Solutions has recently rolled out a new MRI with a wider opening and has devised an ultrasound system capable of greater depth penetration for what it delicately deems "the technically difficult patient."

Each imaging technology has its own obesity-related limitations...

It is absolutely true: there are actual physical limitations to each imaging modality. For example, in ultrasound technology, there is a natural trade off between tissue penetration and image resolution. Lowering the frequency of ultrasound to penetrate deeper, will make the image more fuzzy, and less diagnostic. So there is only so much device manufacturers can do...

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