Governance

The use of computed tomography (CT) for total body screening of asymptomatic patients has not been found to be scientifically justifiable or clinically efficacious. The greatest concerns surrounding this procedure are: (1) that the procedure may lead to the discovery of minor anomalies that have no influence on patient health, and that their identification can lead to added medical examinations with associated risks and increased healthcare costs, (2) professional medical organizations have not established clinical guidelines for appropriate use of total body CT screening due to the lack of scientific evidence demonstrating a health benefit, and (3) because of the lack of a demonstrated health benefit, the exposure to ionizing radiation is not justified. Total body CT screening should not be confused with targeted CT screening in individuals with appropriate risk factors, such as, but not limited to: (a) lung cancer screening with low-dose CT in high-risk patients, (b) colon cancer screening using CT in patients over 50 years of age, and (c) unenhanced cardiac CT performed to detect and quantify ("score") coronary artery calcification in patients at intermediate risk for coronary heart disease. These targeted screening examinations have all been found to be clinically useful in specific populations of patients with appropriate risk factors, and have been endorsed by professional medical societies such as the American College of Radiology, American College of Cardiology, and the American College of Chest Physicians, and organizations such as the American Cancer Society and American Heart Association. The use of total body screening of asymptomatic patients has not received any such support from professional medical societies. Scientists in the AAPM will continuously assess the scientific literature as to the efficacy of total body CT screening and revise this policy statement if and when appropriate.

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