CorE 64 counterpoint: Impose moratorium on 64-slice CT scanning
In his counterpoint to the results of the CorE 64 study presented today in the late-breaking clinical trials symposia at the American Heart Association’s annual Scientific Sessions in Orlando, Fla., Michael Lauer, MD, FACC, FAHA, called for a moratorium of 64-slice CCTA scanning until a large-scale, randomized, multi-center study is done to prove whether the technology saves lives or prevents heart attacks. Lauer, an employee of the National Heart, Lung and Blood Institute (NHLBI), stated that his comments are based on personal opinion, and do not reflect opinions held by NHLBI.
Citing the advantages that mammography has brought to earlier breast cancer detection, Lauer urged that CT will only prove its value “when it brings value…mammography is saving lives…as is ultrasound for [detecting] abdominal aortic aneurysms. AAA is a life-saving test.”
“As physicians, we must first ‘do no harm,’ but cardiac CT brings substantial doses of radiation. And with its noninvasive nature, doctors can be easily tempted to order this test multiple times. We may be causing thousands of preventable cancers…and there is no evidence that 64-slice CT saves lives or prevents heart attacks.
“The time has come for leadership to stop this practice and change the paradigm,” Lauer said. “[This technology] has enormous potential, but before we get carried away, we have to prove it.”
Lauer also said the fact that CorE 64 was presented in the high-profile late-breaking clinical trials symposia sends a “deeper message” that imaging should be subjected to the same rigorous clinical trials evaluation as pharmaceuticals.
Citing the advantages that mammography has brought to earlier breast cancer detection, Lauer urged that CT will only prove its value “when it brings value…mammography is saving lives…as is ultrasound for [detecting] abdominal aortic aneurysms. AAA is a life-saving test.”
“As physicians, we must first ‘do no harm,’ but cardiac CT brings substantial doses of radiation. And with its noninvasive nature, doctors can be easily tempted to order this test multiple times. We may be causing thousands of preventable cancers…and there is no evidence that 64-slice CT saves lives or prevents heart attacks.
“The time has come for leadership to stop this practice and change the paradigm,” Lauer said. “[This technology] has enormous potential, but before we get carried away, we have to prove it.”
Lauer also said the fact that CorE 64 was presented in the high-profile late-breaking clinical trials symposia sends a “deeper message” that imaging should be subjected to the same rigorous clinical trials evaluation as pharmaceuticals.