Abstract
Obesity is an epidemic in the United States and Western World with an associated increasing impact on radiology departments. The increased prevalence of obesity in conjunction with the growing use and success of bariatric surgery results in an influx of obese patients into the health system in need of hospital services and care. Imaging services in particular are in demand in this patient population. Obese patients place special needs upon facilities and imaging equipment and also create technical challenges. This manuscript will address problems and potential solutions for imaging obese patients, specifically with regards to the modalities of radiography, fluoroscopy, computed tomography, and magnetic resonance imaging.
Similar content being viewed by others
References
Uppot RN, Sahani DV, Hahn PF, et al. (2006) Effect of obesity on image quality: fifteen-year longitudinal study for evaluation of dictated radiology reports. Radiology 240(2):435–439. doi:10.1148/radiol.2402051110
Shah S, Shah V, Ahmed AR, Blunt DM (2011) Imaging in bariatric surgery: service set-up, post-operative anatomy and complications. Br J Radiol 84(998):101–111. doi:10.1259/bjr/18405029
Modica MJ, Kanal KM, Gunn ML (2011) The obese emergency patient: imaging challenges and solutions. Radiographics 31(3):811–823. doi:10.1148/rg.313105138
Reynolds A (2011) Obesity and medical imaging challenges. Radiol Technol 82(3):219–239
Flegal KM, Carroll MD, Ogden CL, Curtin LR (2010) Prevalence and trends in obesity among US adults, 1999–2008. JAMA 303(3):235–241. doi:10.1001/jama.2009.2014
Buchwald H (2005) Consensus conference statement bariatric surgery for morbid obesity: health implications for patients, health professionals, and third-party payers. Surg Obes Relat Dis 1(3):371–381
Uppot RN (2007) Impact of obesity on radiology. Radiol Clin North Am 45(2):231–246. doi:10.1016/j.rcl.2007.03.001
Radiology’s Big Challenge: Imaging the “Morbidly Obese”. American College of Radiology. http://gm.acr.org/SecondaryMainMenuCategories/NewsPublications/FeaturedCategories/CurrentHealthCareNews/More/ImagingtheMorbidlyObese.aspx. Accessed on 5 Nov 2011
Overweight and Obesity. Centers for Disease Control and Prevention. http://www.cdc.gov/obesity/data/trends.html. Accessed on February 2012
Puhl R, Brownell KD (2001) Bias, discrimination, and obesity. Obes Res 9(12):788–805. doi:10.1038/oby.2001.108
Rundle RL (2002) U.S.’s Obesity Woes Put a Strain On Hospitals in Unexpected Ways . The Wall Street Journal Online Edition. http://online.wsj.com/article/0,,SB1020194636122710680.djm,00.html
Ginde AA, Foianini A, Renner DM, Valley M, Camargo CAJr (2008) The challenge of CT and MRI imaging of obese individuals who present to the emergency department: a national survey. Obesity (Silver Spring) 16(11):2549–2551. doi:10.1038/oby.2008.410
Uppot RN, Sahani DV, Hahn PF, Gervais D, Mueller PR (2007) Impact of obesity on medical imaging and image-guided intervention. AJR Am J Roentgenol 188(2):433–440. doi:10.2214/AJR.06.0409
Cho M, Kaidar-Person O, Szomstein S, Rosenthal RJ (2008) Emergency room visits after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Surg Obes Relat Dis 4(2):104–109. doi:10.1016/j.soard.2007.05.008
Zingmond DS, McGory ML, Ko CY (2005) Hospitalization before and after gastric bypass surgery. JAMA 294(15):1918–1924. doi:10.1001/jama.294.15.1918
Gastrointestinal surgery for severe obesity: National Institutes of Health Consensus Development Conference Statement (1992) Am J Clin Nutr 55 (2 Suppl):615S-619S
Brolin RE (1996) Update: NIH consensus conference. Gastrointestinal surgery for severe obesity. Nutrition 12(6):403–404
Fisher BL, Schauer P (2002) Medical and surgical options in the treatment of severe obesity. Am J Surg 184(6B):9S–16S
Zhao Y, Encinosa W (2007) Bariatric Surgery Utilization and Outcomes in 1998 and 2004. Statistical Brief #23. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb23.pdf. Agency for Healthcare Research and Quality, Rockville, MD
Buckley O, Ward E, Ryan A, et al. (2009) European obesity and the radiology department. What can we do to help? Eur Radiol 19(2):298–309. doi:10.1007/s00330-008-1154-z
de Bucourt M, Streitparth F, Wonneberger U, Rump J, Teichgraber U (2011) Obese patients in an open MRI at 1.0 Tesla: image quality, diagnostic impact and feasibility. Eur Radiol 21(5):1004–1015. doi:10.1007/s00330-010-2005-2
Miller JC (2011) Imaging obese patients. Radiology rounds: a newsletter for referring physicians, vol 9. Massachusetts General Hospital, Boston
Yanch JC, Behrman RH, Hendricks MJ, McCall JH (2009) Increased radiation dose to overweight and obese patients from radiographic examinations. Radiology 252(1):128–139. doi:10.1148/radiol.2521080141
Yamashita Y, Komohara Y, Takahashi M, et al. (2000) Abdominal helical CT: evaluation of optimal doses of intravenous contrast material—a prospective randomized study. Radiology 216(3):718–723
Bae KT, Seeck BA, Hildebolt CF, et al. (2008) Contrast enhancement in cardiovascular MDCT: effect of body weight, height, body surface area, body mass index, and obesity. AJR Am J Roentgenol 190(3):777–784. doi:10.2214/AJR.07.2765
Heiken JP, Brink JA, McClennan BL, et al. (1995) Dynamic incremental CT: effect of volume and concentration of contrast material and patient weight on hepatic enhancement. Radiology 195(2):353–357
Kondo H, Kanematsu M, Goshima S, et al. (2008) Abdominal multidetector CT in patients with varying body fat percentages: estimation of optimal contrast material dose. Radiology 249(3):872–877. doi:10.1148/radiol.2492080033
Schindera ST, Nelson RC, Lee ER, et al. (2007) Abdominal multislice CT for obese patients: effect on image quality and radiation dose in a phantom study. Acad Radiol 14(4):486–494. doi:10.1016/j.acra.2007.01.030
Huda W, Scalzetti EM, Levin G (2000) Technique factors and image quality as functions of patient weight at abdominal CT. Radiology 217(2):430–435
Silva AC, Lawder HJ, Hara A, Kujak J, Pavlicek W (2010) Innovations in CT dose reduction strategy: application of the adaptive statistical iterative reconstruction algorithm. AJR Am J Roentgenol 194(1):191–199. doi:10.2214/AJR.09.2953
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Carucci, L.R. Imaging obese patients: problems and solutions. Abdom Imaging 38, 630–646 (2013). https://doi.org/10.1007/s00261-012-9959-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00261-012-9959-2