Full-body Scanning Seeks a New Image

Health: The hot new trend has come to Baltimore, but full-body scanning has not won over the traditional medical establishment.

M. William Salganik - SUN STAFF

Published on April 13, 2001
© 2001 The Baltimore Sun

The patient lies down and, for a few minutes, glides through a high-tech doughnut. Then, a radiologist reviews images of the patient's insides from head to knees, checking for everything from cancer to kidney stones.

Full-body scanning - a hot new trend in retail health, but disdained by much of the medical establishment - has come to the Baltimore area. A company called Virtual Physical opened a center in Pikesville a few weeks ago, launched a marketing drive, and is already booked through the end of May. The firm plans another center within three months in Bethesda.

A center in Boca Raton, Fla., plans a Baltimore-area operation within a few months. A third group is close to a decision on whether to open a center here as well.

The scans generally are not covered by health insurance, but "for $795, it's worth it to have the peace of mind," said Michael Castellano, 46, of Baldwin, one of the first patients at Virtual Physical.

And when - unlike in Castellano's case - the scan shows health problems, timely medical intervention can result.

"Sometimes this is what you need to do for an overweight person that's a heavy smoker. When you can see that picture, it might create that lifestyle change," said Jonathan Hazman, president of Virtual Physical.

At his center, the first 57 scans generated 27 recommendations for the patient to see a doctor for follow-up, with a dozen cardiology referrals accounting for the largest number.

Hazman formerly was in the restaurant-supply business. He got into health care six years ago after he was dissatisfied with treatment his grandfather received. Hazman opened what is now a chain of four kidney dialysis centers.

So far, full-body scan centers are being opened by entrepreneurs like Hazman (with the actual review done by radiologists), but not by hospitals or traditional radiology practices, who express strong skepticism about the worth of the scans.

"They cater to the curious and the hypochondriacal and those that are more easily parted from their money than others," said Dr. Barry Daly, chief of abdominal imaging at University of Maryland Medical Center.

"This is cosmetic surgery of preventive health. It's pretty. It's entertaining. But does it do anything for you?" asked Dr. Ed Balbona, chief medical officer of HealthScreen America, a company that has one Florida scanning center - that doesn't do full-body imaging - and plans four more this year.

Dr. Elliot Fishman, a professor or radiology at Johns Hopkins University, isn't quite as dismissive, but isn't exactly enthusiastic, either. "It's kind of on the fringe. We do it if somebody insists," Fishman said.

Computed tomographic (CT) scanning has been around for more than two decades, but full-body scans started just in the past few years, as the scanners got faster.

"To do a whole-body CT scan 10 years ago would have taken an hour, so it was, from a business standpoint, not feasible," said Dr. Harvey Neiman, chairman of the Board of Chancellors of the American College of Radiology, the professional society for radiologists.

A Los Angeles radiologist launched a full-body CT scan center, called HealthView, about three years ago. The procedure got more attention - and more centers began to open - over the past year, as national media discovered it.

The attention spawned more centers.

"One morning at breakfast, I opened USA Today, and there was a story about this guy Harvey Eisenberg doing body scans on the West Coast," said Don Waite, Hazman's partner in the dialysis centers and now in Virtual Physical. "John was on vacation. I called him and said, `Get the paper.' "

About six months later, Virtual Physical opened. Hazman is particularly pleased with the name. "We are to full-body scans what Kleenex is to tissues and Xerox is to copiers," he said.

Because patients pay out of pocket, full-body scanning involves mass marketing; Virtual Physical advertises in The Sun and on radio. Several center operators said they looked to laser eye surgery for a business model - although, unlike the eye surgery, scanning offers the prospect of repeat business.

The scanning centers look for locations where there is disposable income, and try to design a facility that will be convenient and pleasant for the patient.

"This is about being focused on you, looking at you, talking to you," said Barry Blank, a Pikesville businessman who said he may open a center by summer. "This is medical care to people that really want the attention, that's what you're talking about."

Besides Blank, the Baltimore market is being eyed by Alan Sternberg, founder of Innovative Medical Imaging, a center in Boca Raton. He plans to open a center soon in Miami, one in the next four months in Baltimore and a dozen in all over the next 15 months.

More centers - and more media attention - has also meant more attention from the College of Radiology, which issued a statement in November saying, "To date there is no evidence that total body CT screening is cost effective or effective in prolonging life."

Neiman, who is chairman of the department of radiology at Western Pennsylvania Hospital in Pittsburgh as well as an officer of the College of Radiology, said a quick full-body scan is not nearly as likely to find problems as a focused look at a particular organ for a particular reason - symptoms, family history or risk factors such as smoking.

On the other hand, he said, the full-body scans are likely to turn up many benign lumps and other things which will lead to more tests, more expense and more worry, but not better health.

"Add in the exposure to X-rays, which, by the way, induce cancer, and there's a downside that would have measurable cost in dollars and anxiety," said Philip Drew, president of Concord Consulting Group.

The center operators counter that radiation exposure from the scan is negligible and, while the procedure isn't error-free, it does catch diseases early in some people.

"Was it worthwhile to the person who found cancer on the liver?" asked Waite. "If you have the money, and you have the freedom, why would you not do it?"

As the scans develop a longer track record, their value will be recognized, the operators say. Sternberg predicts that within a few years, "good hospitals -- Duke, UCLA, Johns Hopkins - will open centers."

But Daly, of the University of Maryland, said it's not even correct to say there's disagreement about the value of full-body scanning. "I wouldn't characterize it as a debate," he insisted. "I would say there is no reputable body or scientist that says it is of any virtue whatsoever."