Q+A CENTER

At the RSNA show, Dr. Raul Uppot says that current radiology equipment is limited in its effectiveness when the patient is obese. Obesity, he says, can limit the imaging equipment used to diagnose a patient.

"Hospital radiology departments are increasingly unable to adequately image and assess obese patients," he says.

Uppot, a fellow in abdominal imaging and interventional radiology at Massachusetts General Hospital (Boston), conducted a 15-year retrospective study of all radiologic exams at the hospital to determine how imaging was limited by the patient's size. The percentage of radiology reports that were labeled as limited because of patient obesity nearly doubled over the 15-year period, from 0.1 percent in 1989 to 0.19 percent in 2003. Imaging exams most often cited were abdominal ultrasound (1.5 percent), chest X-ray (0.08 percent) and abdominal CT (0.04 percent.)

Uppot says that ultrasound waves penetrate through body tissue to produce a diagnostic image. The quality of the image is compromised by even slightly overweight patients, according to Uppot. He says that X-rays are limited by inadequate penetration and film size and CT and MRI technology are limited by the amount of weight the equipment can support and the size of the area designed to accommodate the patient.

"Manufacturers need to think about design changes and technological advancements to obtain quality imaging in larger patients," says Dr. Uppot. "In the meantime, radiologists need to be aware of the limitations of their current imaging equipment and optimize current protocols and equipment settings to accommodate America's fattening population."