hospitals with 256 Slice CT scan?

[lupin]

I'm wondering if anyone knows what hospitals have 256 slice CT scanners in Bangkok?

Most I have spoken to have older 64 or 128 slice models... Bangkok Heart hospital and Bumrungrad (I think) have 256 slice.

 

Any others?

 

Cheers

 

[Sheryl]

Samitivej has the 640 slicer

https://www.samitivejhospitals.com/en/640-slice-ct-scanner/

 

 

[lupin]

55 minutes ago, Sheryl said:

Samitivej has the 640 slicer

https://www.samitivejhospitals.com/en/640-slice-ct-scanner/

 

thanks so much for the reply, much appreciated

 

[Lumbini]

Samitivej has the 640 slicer
https://www.samitivejhospitals.com/en/640-slice-ct-scanner/
 
 

Thanks Sheryl [emoji1317] that is the latest and greatest and the best for getting a calcium score . Why do you think getting a scan and a calcium score cost so much in Thailand compared to the states where it is about 100 dollars ? Seems getting a scan and calcium score that is so useful here in Thailand is one of the few procedures / test that is much more here than in the states .

PS ... also when I called today Samitivej Hospital asking price for calcium score using the 640 slice scan was 30,000 baht so that’s about twice the price of Bangkok Heart Hospital that uses 256 slice scanner . But again all of these prices are over twice as much as in the US for a calcium score using the same scanner . So why this valuable calcium score procedure done with scanning so much more in Thailand than in the US where things are usually much more expensive than procedures here ? Any input would be helpful and thanks again for the info on the availability of the 640 slice equipment availability here .

[Sheryl]

The problem with things like CT and MRI are that the machines are very, very expensive (millions of dollars apiece) and become obsolete pretty fast, so the hospital or clinic has to recoup its outlay with profit within a very short period of time. In places like India where due to large population the sheer volume of tests is high, they can do that at a much lower price than they can in a place like Thailand where population is comparatively small (especially when you exclude the majority of Thais, as they get their care through the government system) thus the volume of tests done  small. USA would fall in between those two extremes.

 

[Lumbini]

Chula has just gotten a 192 slice state of the art dual scanner installed to do calcium scoring now so I had my calcium scan/score done there.

 

Chula is in the process of updating many buildings and equipment and it’s quite impressive . I suggest everyone to do this test as it’s really useful in predicting coronary risk that other tests miss and fast becoming a standard as heart disease now affects half of the US population with its main roots in inflammation from insulin resistance that also effects half of US population that are either diabetic or pre dietetic .

 

 

 

 

[FracturedRabbit]

I paid 2900 for a CAC scan at BPH Pattaya (was a promotion price) with a 128 slice scanner. This was without contrast (you don’t need a contrast injection for a CAC score). In 2017 I had a scan with contrast which also produced a CAC on a 64 slice machine, cost me 18,000 baht.
Perhaps they are quoting you “with contrast” which you don’t need for just a CAC score?
Not sure how much difference you will see between different slices. My CAC on the 128 slice was 6% higher than the 64 slice taken 14 months earlier, which I took as an indication that I have brought the inflation/ insulin resistance under control.


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[Lumbini]

What was your score and why did you do another scan with dye after the first scan to get score without dye if you don’t mind me asking ?

 

Great you are investigating this FracturedRabbit ... I started testing fasting insulin when I check fasting glucose and HA1c and that has really uncovered even more and a few months ago did a 100 gram three hour Glucose Tolerance Test OGTT with insulin and glucose tested at each hour interval not just glucose . That test was really affordable and along with the fasting insulin, fasting glucose and HA1c I learned so much and all done one morning after I fasted night before and very cheap . I guess Dr. does not order unless you ask because they want to have you as a regular customer when you turn diabetic and have coronary artery and heart disease . No money in health the profit seems to be in disease management not health care .

 

 

 

 

[FracturedRabbit]

18,000 baht was with contrast and at Pyiathai, Sri Racha. The score was 134.
2,900 was without contrast at BPH and the score was 146, 14 months after the first scan.
Expect your quote is for no contrast.

For an accurate comparison you really need the same machine and maybe even the same operator, but as annual CAC increases seem to run at at least 25%, I think my increase is ok. I am not taking statins....

https://ac.els-cdn.com/S0735109705010326/1-s2.0-S0735109705010326-main.pdf?_tid=faf35a91-00db-4b55-8b18-dd9bf5a0c27e&acdnat=1551106884_59515b22ec71a4ff3aefb918bb4b5c99


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[lopburi3]

15 hours ago, Lumbini said:

I suggest everyone to do this test as it’s really useful in predicting coronary risk that other tests miss

You have to balance with age and the risks involved from the high radiation exposure of CT scans however (cancer is a known risk).  Believe most of us would prefer not to live in Chernobyl (and I am saying this as a CT scan user due cancer).

[Lumbini]

You have to balance with age and the risks involved from the high radiation exposure of CT scans however (cancer is a known risk).  Believe most of us would prefer not to live in Chernobyl (and I am saying this as a CT scan user due cancer).

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[FracturedRabbit]

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The dose for a CAC scan seems comparatively low:
“Our results demonstrate that coronary calcium scoring results in a mean exposure of 1 mSv across multiple scanners and centers. We found no significant difference in effective dose between genders, weight classes, or ages up to age 75 years. It should be noted that in large patients, the organ doses cannot necessarily go up just because volume CTDIvol and mSv goes up. A great deal of attenuation occurs in the adipose tissue. These findings do not mean that large patients receive larger organ doses. Prior reports of doses and subsequent cancer risks are most commonly estimated by a study by Kim et al. [6] which calculated cancer risks based on a median effective dose of 2.3 mSv (more than twice the current doses observed)”

As an aside, I spent a week in Chernobyl three months after my scan! Still not glowing.


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[lopburi3]

9 minutes ago, FracturedRabbit said:

Our results demonstrate that coronary calcium scoring results in a mean exposure of 1 mSv across multiple scanners and centers.

And who is this "our"?  Information I have is there is no standard and that it varies greatly between centers and that 3 mSv (one year background radiation) is normal (dated 2018) for heart calcium check.  

https://www.radiologyinfo.org/en/pdf/safety-xray.pdf

 

[FracturedRabbit]

And who is this "our"?  Information I have is there is no standard and that it varies greatly between centers and that 3 mSv (one year background radiation) is normal (dated 2018) for heart calcium check.  
https://www.radiologyinfo.org/en/pdf/safety-xray.pdf
 

Sorry,should have pasted source:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752888/

I did a lot of research before deciding to have a second scan and the general consensus was that a CAC scan typically used around 0.7 msv.

We all have to evaluate the perceived risk and act accordingly. For me it is important to track if I am beating atherosclerosis, your risk assessment may well be different.


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[Sheryl]

You have to balance with age and the risks involved from the high radiation exposure of CT scans however (cancer is a known risk).  Believe most of us would prefer not to live in Chernobyl (and I am saying this as a CT scan user due cancer).

Indeed.

 

Calcium scan is not recommended for routine scanning of the general public, risks would outweigh benefits.

 

It is useful for people who are either symptomatic or have known risk factors. Especially if stress test is negative or inconclusive (about 14% of people with negative stress test still have CAD). . With a positive stress test in a symptomatic person or person with risk factors, most Drs would recommend going straight to angiogram.

 

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[lopburi3]

12 minutes ago, Sheryl said:

With a positive stress test in a symptomatic person or person with risk factors, most Drs would recommend going straight to angiogram.

Indeed exactly what my doctor said when EKG bad (preop test for a thyroid operation) and stress test confirmed - could do CT but best go angiogram directly, called doctor in and within 3 hours had 2 stents in place.  

[FracturedRabbit]

For those planning to use CAC scanning as a means of tracking the progress of their atherosclerosis, this paper includes a table (table 3) showing average  increase in CAC scores for around 1,000 subjects over a two and four year period. 

 

https://www.sciencedirect.com/science/article/pii/S0735109705010326

 

 

[FracturedRabbit]

And this paper shows the dramatically reduced risk of a cardiac event if you can keep the annual CAC increase below 15%.

 

https://www.ahajournals.org/doi/full/10.1161/01.ATV.0000127024.40516.ef

[Lumbini]

You can have great scores on all the standard tests and be symptom free with great blood pressure and fit and still have a stroke or heart attack so the scan in the neck with ultrasound to get CIMT score and calcium score scan is real opportunity to not miss anything and both tests are cheap .

 

 

Maybe Dr. don’t order because no drugs they can sell you to bring calcium score down only lifestyle changes that are free so Dr. and drug company can not make anything . It’s like now I test insulin when I test Ha1c and fasting glucose and that tells much but Dr.’s don’t order because no drugs they can sell to bring insulin down again only lifestyle. The money is in sick care it seems grating symptoms with drugs and procedures not real healthcare .

 

If Susan had gotten a scan to get calcium score she would have had a heads up and could have taken steps to reduce blockage possibly years before with serious lifestyle and diet changes

 

 

 

[FracturedRabbit]

On 2/25/2019 at 10:27 PM, Lumbini said:

What was your score and why did you do another scan with dye after the first scan to get score without dye if you don’t mind me asking ?

 

Great you are investigating this FracturedRabbit ... I started testing fasting insulin when I check fasting glucose and HA1c and that has really uncovered even more and a few months ago did a 100 gram three hour Glucose Tolerance Test OGTT with insulin and glucose tested at each hour interval not just glucose . That test was really affordable and along with the fasting insulin, fasting glucose and HA1c I learned so much and all done one morning after I fasted night before and very cheap . I guess Dr. does not order unless you ask because they want to have you as a regular customer when you turn diabetic and have coronary artery and heart disease . No money in health the profit seems to be in disease management not health care .

 

 

 

 

Sorry, I didn't answer the "why".
I initially went to see a heart specialist because I was feeling consistently light headed, something wasn't right. A stress test revealed a problem with my heart once it hit 138bpm; it couldn't cope!
Doc offered an angiogram, but suggested a scan with contrast as a cheaper and less risky alternative (he  had me at "cheaper!). This revealed that one artery had a 50% blockage and another 37%; the other two were clear. 

As well as showing the problem, the scan also kicked out a CAC score. The second scan, 14 months later and without contrast, was to see how the disease had progressed and whether my lifestyle changes had helped (the doc gave me statins which I threw away).

 

I wrote something about my experience: https://www.pattayadays.com/2019/02/attacking-the-heart-attack/

[hnsighttha]

Anyone tried this?  https://www.samitivejhospitals.com/en/640-slice-ct-scanner/

 

640 slice scanner!  ????  (didn't get a price quote yet)

[hnsighttha]

On 2/25/2019 at 9:57 PM, Lumbini said:

What was your score and why did you do another scan with dye after the first scan to get score without dye if you don’t mind me asking ?

 

Great you are investigating this FracturedRabbit ... I started testing fasting insulin when I check fasting glucose and HA1c and that has really uncovered even more and a few months ago did a 100 gram three hour Glucose Tolerance Test OGTT with insulin and glucose tested at each hour interval not just glucose . That test was really affordable and along with the fasting insulin, fasting glucose and HA1c I learned so much and all done one morning after I fasted night before and very cheap . I guess Dr. does not order unless you ask because they want to have you as a regular customer when you turn diabetic and have coronary artery and heart disease . No money in health the profit seems to be in disease management not health care .

 

Where did you get the blood tests done if I may ask?  And how much did they charge?