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Obesity remains a public health epidemic. It is defined as a body mass index (BMI) of more than 30 kg/m2, (BMI of
greater than 40 kg/m2 for severe, class 3, or morbid obesity). Along with increased abdominal or visceral obesity, an
elevated BMI is associated with increased risk for certain malignancies, postsurgical and anesthetic complications, renal,
metabolic, cardiovascular, musculoskeletal, liver, thromboembolic, and lung disease. Greater incidence of medical and
surgical complications warrants more diagnostic imaging of obese patients, which is challenging. Severely obese patients have
difficulty lying supine during image acquisition. Scanning tables may not accommodate morbidly obese patients beyond a
certain weight or they may not fit through a CT gantry or closed MRI tunnel. Voltage or current settings on CT scanners or
radiotracer doses may be adjusted to increase the amount of radioactivity to improve tissue penetration to overcome the tissue
attenuation resulting from a large body habitus. A larger body habitus mandates a higher dose of intravenous radiographic
contrast in patients referred for contrast-enhanced imaging studies, which could be problematic in patients with underlying
renal disease. The quality of sonographic images is suboptimal due to poor acoustic penetration into deeper tissues. Imageguided
interventions in the obese carry risks similar to those of surgery. Such challenges associated with imaging of severely
obese patients must be addressed, especially given the high prevalence of obesity and the increasing frequency of diagnostic
imaging in daily clinical practice to optimize protocols for patient positioning, acquisition parameters, dose of radioactivity
and contrast.
Biography
Feraas Jabi has completed his MD at the University of Balamand in Lebanon and nuclear medicine residency at the University at Buffalo, where he currently serves as clinical Assistant Professor. He also heads the nuclear medicine department at Buffalo General Medical Center. He is extensively involved in radiology research in general and nuclear medicine in particular. He also currently serves as editorial review board member for two peer-reviewed journals.