Unindicated multiphase CT scans in non-traumatic abdominal emergencies for women of reproductive age: a significant source of unnecessary exposure

Giannitto, Caterina; Campoleoni, Mauro; Maccagnoni, Sara; Angileri, Alessio; Grimaldi, Maria; Giannitto, Nino; Piano, Francesca De; Ancona, E; Biondetti, Pietro; Esposito, A.

doi:10.1007/s11547-017-0819-6

Cited by 23 publications

(12 citation statements)

References 24 publications

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“…Although prior studies have reported on the frequency of multiphase CT protocols and the associated radiation dose, these studies focused on single-institutional data from most developed countries. 2,10 -14 In contrast, our study reports the frequency and radiation dose burden associated with the multiphase scanning in multiple institutions from the developing countries in 4 continents. The lack of justification for multiphase CT reported in our study is similar to those in prior studies.…”

Section: Discussionmentioning

confidence: 96%

“…The lack of justification for multiphase CT reported in our study is similar to those in prior studies. 2,10 -14 For example, Guite et al reported that 61% patients (307/500) had multiphase abdomen–pelvis CT, and 86% (264/307) of these patients had at least one unjustified phase per ACR Appropriateness criteria. 2 We also observed that 2 of 3 of the multiphase abdomen–pelvis CT had one or more unjustified phases.…”

Section: Discussionmentioning

confidence: 99%

“…3 -5 To address these issues, good scanning practices must be adopted to optimize radiation doses to the patient to the minimum necessary to achieve the required diagnostic objective. 6 -13 Adherence to the optimization principles requires an understanding of scanning practices, protocols, and technologies.…”

Section: Introductionmentioning

confidence: 99%

“…The multiphase CT examinations are associated with much higher radiation doses as compared to the single-phase CT examinations in the same body region. Although single-center data on the use of multiphase routine chest and abdomen–pelvis CT from developed countries are available, 2,10 -16 there are little to no multi-institutional data from the developing countries. Thus, the purpose of our study was to assess the frequency, appropriateness, and radiation doses associated with multiphase CT protocols for routine chest and abdomen–pelvis examinations in 18 countries.…”

Section: Introductionmentioning

confidence: 99%

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Use of Multiphase CT Protocols in 18 Countries: Appropriateness and Radiation Doses

et al. 2020

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Purpose: To assess the frequency, appropriateness, and radiation doses associated with multiphase computed tomography (CT) protocols for routine chest and abdomen–pelvis examinations in 18 countries. Materials and Methods: In collaboration with the International Atomic Energy Agency, multi-institutional data on clinical indications, number of scan phases, scan parameters, and radiation dose descriptors (CT dose–index volume; dose–length product [DLP]) were collected for routine chest (n = 1706 patients) and abdomen–pelvis (n = 426 patients) CT from 18 institutions in Asia, Africa, and Europe. Two radiologists scored the need for each phase based on clinical indications (1 = not indicated, 2 = probably indicated, 3 = indicated). We surveyed 11 institutions for their practice regarding single-phase and multiphase CT examinations. Data were analyzed with the Student t test. Results: Most institutions use multiphase protocols for routine chest (10/18 institutions) and routine abdomen–pelvis (10/11 institutions that supplied data for abdomen–pelvis) CT examinations. Most institutions (10/11) do not modify scan parameters between different scan phases. Respective total DLP for 1-, 2-, and 3-phase routine chest CT was 272, 518, and 820 mGy·cm, respectively. Corresponding values for 1- to 5-phase routine abdomen–pelvis CT were 400, 726, 1218, 1214, and 1458 mGy cm, respectively. For multiphase CT protocols, there were no differences in scan parameters and radiation doses between different phases for either chest or abdomen–pelvis CT ( P = 0.40-0.99). Multiphase CT examinations were unnecessary in 100% of routine chest CT and in 63% of routine abdomen–pelvis CT examinations. Conclusions: Multiphase scan protocols for the routine chest and abdomen–pelvis CT examinations are unnecessary, and their use increases radiation dose.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of Multiphase CT Protocols in 18 Countries: Appropriateness and Radiation Doses

et al. 2020

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“…This parameter can be quantitatively defined and derived by DWI images expressing the entity of tissues restriction of diffusion (35). The strong point of DWI compared to dynamic contrast enhanced (DCE)-MRI is its high sensitivity to identify histological changes in the microscopic environment without need for contrast medium administration, which should be avoided in cases of pregnancy and impaired renal function (36)(37)(38)(39)(40).…”

Section: Basic Physics Of Diffusion-weighted Imaging (Dwi)mentioning

confidence: 99%

Apparent diffusion coefficient magnetic resonance imaging (ADC-MRI) in the axillary breast cancer lymph node metastasis detection: a narrative review

et al. 2020

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The presence of axillary lymph nodes metastases in breast cancer is the most significant prognostic factor, with a great impact on morbidity, disease-related survival and management of oncological therapies; for this reason, adequate imaging evaluation is strictly necessary. Physical examination is not enough sensitive to assess breast cancer nodal status; axillary ultrasonography (US) is commonly used to detect suspected or occult nodal metastasis, providing exclusively morphological evaluation, with low sensitivity and positive predictive value. Currently, sentinel lymph node biopsy (SLNB) and/or axillary dissection are the milestone for the diagnostic assessment of axillary lymph node metastases, although its related morbidity. The impact of magnetic resonance imaging (MRI) in the detection of nodal metastases has been widely investigated, as it continues to represent the most promising imaging modality in the breast cancer management. In particular, diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values represent additional reliable non-contrast sequences, able to improve the diagnostic accuracy of breast cancer MRI evaluation. Several studies largely demonstrated the usefulness of implementing DWI/ADC MRI in the characterization of breast lesions. Herein, in the light of our clinical experience, we perform a review of the literature regarding the diagnostic performance and accuracy of ADC value as potential pre-operative tool to define metastatic involvement of nodal structures in breast cancer patients.

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Risks of Radiation Exposure During Abdominopelvic CT Procedures at Mohamed VI University Hospital of Oujda, Morocco

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Semghouli

Hakam

et al. 2020

Innovations in Smart Cities Applications Edition 3

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Unindicated multiphase CT scans in non-traumatic abdominal emergencies for women of reproductive age: a significant source of unnecessary exposure

Cited by 23 publications

References 24 publications

Use of Multiphase CT Protocols in 18 Countries: Appropriateness and Radiation Doses

Use of Multiphase CT Protocols in 18 Countries: Appropriateness and Radiation Doses

Apparent diffusion coefficient magnetic resonance imaging (ADC-MRI) in the axillary breast cancer lymph node metastasis detection: a narrative review

Risks of Radiation Exposure During Abdominopelvic CT Procedures at Mohamed VI University Hospital of Oujda, Morocco

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