Find heart disease or cancer early, when it's possibly most treatable, and you're likely to enjoy the best possible outcome.

Mike Huish is building a business around the "early detection" concept. AccuScan Health Imaging, located in The Gateway in downtown Salt Lake City, uses a state-of-the-art, GE ultrafast Computed Tomography scanner to take an internal, 3-D image of the body. The test, which takes 15 minutes, creates cross-section images (or slices) of organs to look for nodes, tumors, polyps or anything that isn't normal. In the heart, it searches for calcium deposits, which might indicate a build-up of plaque. The goal is to find problems before they're symptomatic.

"I think more people are taking control of their own health, and this is another tool for that," said Huish, who owns AccuScan, the first company offering the service in Utah. "We're combining a proven technology and medical expertise" that people can avail themselves of without a referral from a physician.

The CT scan is done by a certified radiology technologist. The results are read by one of two radiologists (both also work in area hospitals) who reviews them with a customer right away. Later, customers receive the test on CD-ROM, along with a written report. If something suspicious is found, AccuScan will, at a customer's request, provide the scan and pertinent information to a designated physician. In some cases, Huish said, AccuScan will help a customer find a doctor of the right specialty for more tests or treatment.

Since the company opened just a few days ago, it has found colon polyps that could one day become cancer, a lung tumor, several people with calcium in their hearts, indicating they could have coronary disease and, in an individual who came in specifically because of severe headaches, a brain tumor.

It's a diagnostic tool, but not necessarily a diagnosis by itself, Huish, staff radiologist Dr. Don Nichols and others agree. Depending on the condition found, the scan alone may not be able to tell if something is benign or malignant, for instance.

Insurance doesn't generally cover the scans, though some HMOs will. A full body scan, which includes heart, lung and general abdominal scan costs $960. A virtual colonoscopy is also $960. The full body scan and the virtual colonoscopy can be combined for $1,420. A heart scan alone is $495; a lung scan is $295. AccuScan offers a separate brain scan or bone density exam, as well.

The radiologists use the same criteria they use with their work in area hospitals, based on their years of experience, Nichols said. They don't hesitate to encourage patients to get medical follow-ups with their own physicians if something looks like a problem. And they do a lot of lifestyle counseling on conditions that seem relatively benign. If you're a smoker, for instance, and the test doesn't find anything particularly concerning, Nichols will still talk about the benefits of quitting and how the lung rejuvenates when you stop.

He also makes it clear what the scan doesn't see. It's hard to get a good look at a pancreas to see if there's a mass, for example. People interested in gall bladder disease should avoid eating before the scan, since it will obscure that. And this is not designed to detect breast cancer, though it will occasionally show one.

The scan is likely to find gall and kidney stones and even the onset of osteoporosis, said sales executive Matt Anderson. It's not very helpful for arthritis, because that normally occurs in joints that aren't scanned. It will also find enlarged or irregularly shaped organs, cysts and lung nodules— conditions that may be dangerous or benign. And that's part of the controversy that has sprung up in other cities where similar businesses have set up shop.

The American College of Radiology last year said it doesn't endorse the scanning, because it "will lead to the discovery of numerous findings that will not ultimately affect patients' health, but will result in increased patient anxiety, unnecessary follow-up examinations and treatments and wasted expense."

Huish believes mammography sparked the same reaction when it debuted. Those questions are still raised in some quarters. People debate how cost-effective mammography is and how often a woman should be screened.

The critics are more positive about whole body scanning for patients over 50 who should be looking for specific diseases based on family history or for smokers who want to know if they have lung disease. In general, though, they're waiting for clinical trials to prove the efficacy of the whole-body scans.

Dr. Maryellyn Gilfeather, vice chairwoman of the radiology department at the University of Utah, sees pluses and minuses with the scans. She cites radiation exposure as a concern that hasn't been resolved: "It's a pretty hefty radiation dose for someone who is asymptomatic, fine, has no weight loss and no pain. For them, the chances of finding something are small. The risk-benefit may not be worth it. . . . And how often do you get screened and what's the radiation exposure?"

On the other hand, she said, "it's a reasonable screen for a lot of diseases," including some seldom screened unless a person becomes symptomatic.

"The negative side of this is that it's expensive, and I don't know how savvy most patients are," she said. Patients might be able to get diagnostic tests through their physicians if they're worried about a specific condition. And she's concerned a scan that doesn't detect a problem will lead people to believe they're home-free and they won't realize their health could change.

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"Big studies need to be done where you take two populations of similar patients and half get screened and the other half don't and you look at the 10-year survival and see if the screening has been effective," she said. But that's in the future.

Some physicians have had the scans, others won't. Like many practitioners, Gilfeather ends up in the middle. She's unlikely to be scanned herself, she said. If her parents, in their 60s and at an age where more medical conditions do develop, wanted to get a scan, she said she wouldn't encourage it. But she likely wouldn't discourage it, either.

More information on the AccuScan is available by calling 456-7226.


E-MAIL: lois@desnews.com

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