Obese patients are straining imaging tools

Radiologists are finding that clear images are difficult to obtain -- especially using abdominal ultrasounds.

By Susan J. Landers, AMNews staff. Sept. 18, 2006.

Washington -- The burden of the nation's obesity epidemic is being carried on many levels.

The obvious -- that of increases in related morbidity and mortality -- continues to raise public health alarms. But downstream nuts-and-bolts issues involving the treatment of these patients also are emerging.

Not only are hospitals requiring larger wheelchairs and beds to accommodate patient's added girth, but radiology equipment is not always up to the task at hand. The problem is becoming more evident as growing numbers of extremely obese patients turn to gastric bypass surgery.

A study in the August Radiology found that rising obesity in the United States doubled the number of inconclusive diagnostic imaging exams between 1989 and 2003. Researchers assessed all exams done during that time at Massachusetts General Hospital to determine the effects of weight gain on imaging quality and diagnosis.

The problem is becoming more obvious, said the study's lead author, Raul Nirmal Uppot, MD, a radiologist at MGH. "No longer are obese people simply staying at home and living their lives, they are coming into the hospital to get gastric bypass surgery done."

At MGH, all patients undergo postoperative imaging to ensure that there are no leaks in the surgery site, the researchers said. But getting a clear image or even fitting a patient on a radiology table or through an imaging machine's "doughnut hole" opening is becoming more difficult.