This has been reported by the radiologists. With a population inclining towards obesity the problem is becoming more severe. “We noticed over the past couple of years that obesity was playing a role in our ability to see these images clearly,” said Dr. Raul Uppot, a radiologist at Massachusetts General Hospital.
Radiologists when writing up reports state: “These images are limited due to body habitus.” for a subject whose scans were not possible on grounds of obesity. These include standard X-rays, computer assisted X-rays known as CT scans, magnetic resonance imaging (MRI) and positron emission tomography (PET). These scans are used to look for tumors, blood clots, broken limbs and other injuries and diseased organs.
“Overall, 7,778 or 0.15 percent of 5,253,014 reports were habitus limited,” is stated in the August issue of the journal Radiology. “It essentially doubled over the last 15 years,” Uppot said. The researchers looked more closely at the records of 200 of the patients, who weighed, on average, 239 pounds (108 kg).
“It is a major issue because the patient may still have a tumor, the patient may have appendicitis, the patient may have other inflammatory processes,” Uppot said. “This is affecting radiologists all over the country.”
Ultrasounds are most affected, Uppot said.
“In an obese person because the ultrasound beam does not get to the organs or get to them adequately enough we cannot get a picture. It looks like a snowstorm. I don’t know if you have seen those televisions where it is just whiteout? It looks like that.”
An MRI can get a good picture if the patient can fit into the tube or get onto the table, Uppot said. Some manufacturers have started to make MRI machines with larger bore holes, but with the cost in the millions of dollars per machine, only large groups or institutions can afford them. “It is a market out there. People who are taking advantage of it are making money,” Uppot said. “We are in the process of buying and installing three of these machines.” One problem is with gastric bypass surgery, where the patients are by definition obese, Uppot said.
“If there is some complication abdominal pain or and infection or fever they are invariably at higher risk of not being able to be imaged with a CT or MRI,” Uppot said. “For the surgeon, he doesn’t want to take the patient back to surgery to explore to see what the problem is,” he added. “For the patient, not knowing what is going on is a big issue. If you tell a patient ‘I am sorry — we just can’t sit you on our CAT scanner’, that is devastating to hear.”
The picture is pretty dark but it is true.