"Probably the single most important test in Medicine!"

Description and Indications

Some doctors call the EBCT Scan procedure the "mammogram of the heart" because of its capability of detecting heart disease at an early stage. The EBCT Scan is a simple non-invasive test used for early detection of heart disease. With early detection and modifying your risk factors, the potential for advanced heart disease may be significantly reduced and in some cases reversed.

Latest research shows that coronary calcium detected by EBCT predicts heart attack risk more than all the traditional risk factors. This holds true for woman, men, whites, blacks, Hispanics and Asians. Refer to EBCT Research section for these studies.

The EBCT Scan is a painless test that takes about 10 minutes. The process is similar to taking an x ray of your body. An individual lies on the scanner table and multiple images of the heart are taken. A cardiologist from the Orange County Heart Institute then interprets these images to determine the amount of calcified plaque in the arteries.

Minimal Calcification	Moderate Calcification	Severe Calcification

When plaque develops in the coronary arteries, it starts as small streaks of fat on the inner lining of the arteries. As the plaque progresses, calcium is deposited, forming a composite plaque. The EBCT scan detects the calcium which correlates with the total amount of plaque in the arteries.

The best scanning technology to detect coronary calcium is the Electron Beam CT scan, also referred to as the EBCT or EBT scan. The EBCT scan is a unique type of CT scanner that was designed for speed to detect plaque in the coronary arteries. The electron beam sweeps from behind the heart at an extremely high speed, literally freezing the image of the moving heart. The advantage is that the detection of calcium deposits is very accurate, fast and extremely low radiation is delivered to the body.

Why do we use EBCT Scans instead of multislice CT for screening?

Imaging the heart presents unique challenges compared to tests to image other organs of the body. The speed of the EBCT heart scan makes it a very specialized CT scan for screening heart disease.

Whenever attempts are made to screen people for any type of disease, especially a disease like heart disease (which is so deadly and the most wide-spread of any known disease), the tools used to screen for the disease must meet these criteria:

• Extremely safe ( meaning very low radiation)

• Relatively inexpensive (cost is less than most stress tests)

• Very accurate ( coronary calcium means coronary disease)

• Large body of scientific evidence validating the benefits (thousands of scientific papers on EBCT scans)

• Large body of scientific evidence of how to modify the disease process if disease is found

EBCT scans are the only technology to meet these criteria when screening for coronary disease. EBCT scans are the gold standard. Basically, for now and long into the future, EBCT scans will be the preferred scan for coronary calcium screening because of speed, low radiation doses, and the vast number of studies performed using EBCT scans.

However, technology is rapidly changing and newer varieties of CT scans will undoubtedly be developed that will compete with the EBCT scan for heart imaging. To meet these needs, OC Vital Imaging now has a GE 64 Slice CT/PET for diagnostic testing for CT angiograms of all blood vessels, especially of the heart. A “slice” essentially refers to how many tiny lenses are in the CT camera—the more lenses or slices, the greater the picture detail and the more surface area of the heart covered in a certain period of time.

The bottom line is this:
The EBCT scan is the screening tool of choice for coronary calcium and full-body screening. If your doctor requests that you have a CT angiogram, request it on an EBCT scan or 64-slice CT. Also request that it be done at a center under the direction of cardiologists with experience in CT angiography.

What is a calcium score?

As the soft cholesterol plaque progresses in the lining of the coronary artery, calcium is deposited, forming a composite plaque. The calcium that is detected in all the coronary arteries is reported as a “calcium score”. This is calculated by a complex formula for each piece of calcium in every piece of each coronary artery. The calcium score is the sum total of all the calcified plaque in all of the coronary arteries. Think of the calcium score as a plaque score. If you have coronary calcium, you have plaque, which is also referred to as coronary atherosclerosis or “hardening of the coronary arteries”. The CT technician must evaluate each artery to assure that the plaque is indeed in the artery and not another piece of the heart. Calcium scores are much more reliably detected with an EBCT scanner than a multi slice CT scanner, especially scores less than 200. It is important to detect coronary calcium or plaque as early as possible so medical treatment can be started to prevent advanced disease that may lead to a heart attack or the need for coronary bypass surgery. The higher the calcium score, the higher your chance of having a heart attack or needing coronary bypass surgery, unless, you are treated appropriately with medications. The higher the calcium score, the more vigorously your cholesterol needs to be treated.

The calcium score is more predictive of your chance of having a heart attack than all the traditional risk factors. Know you calcium score is more important than knowing you cholesterol! Only EBCT scanning can provide this information.

How does a stress test compare to an EBCT scan?

A coronary artery has to be narrowed about 60% to 70% before symptoms are noted and before a stress test will detect any abnormalities. However, half of all heart attacks occur without warning because the artery was not narrowed enough to restrict blood flow and cause symptoms. Suddenly, the minor plaque ruptures, forming a clot within the channel of the coronary artery, closing off the artery resulting in a heart attack. Only an EBCT heart scan can detect and quantify this plaque that is not yet restricting blood flow but puts you at risk for a heart attack. Stress testing can only pick up advanced narrowing that often requires surgery or intra coronary stents. Numerous scientific studies show that coronary calcium is the best predictor of a heart attack risk, and more predictive than all the traditional risk factors combined.

What separates OC Vital Imaging from other imaging centers?

The skill and training of the technician is paramount in obtaining accurate calcium scores. Each heart scan and calcium score at OC Vital Imaging is reviewed and calculated by a highly experienced technician. Then our nurse or nurse practitioner review the study again, and finally a cardiologist reviews the final report before it is signed. Also, our EBCT scanner is carefully calibrated and aligned each morning and undergoes costly preventive maintenance service monthly to assure optimum accuracy and performance. OC Vital Imaging has performed more EBCT heart scans and CT angiograms than most places in the country. Dr. Santora, Dr. Alimaddadian and Dr. Azer, oversee our CT angiography program. Drs. Santora and Alimaddadian each have over 25 years experience as invasive and interventional cardiologists. Dr. Maged Azer also oversees the PET perfusion scans and is the Director of Nuclear Imaging at the Orange County Heart Institute.