Clinical impact of incidental diagnosis of disease on non-contrast-enhanced helical CT for acute ureteral colic

Ather, M Hammad; Memon, Wasim; Rees, Jeffrey

doi:10.1053/j.sult.2004.10.005

Cited by 14 publications

(7 citation statements)

References 23 publications

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“…Advances in cross-sectional imaging have led to the discovery of innumerable incidental liver lesions [2][3][4]. Such lesions will be detected in up to 30% of individuals older than 40 years [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Although most are benign, in many cases, further workup can be difficult to avoid.…”

Section: Nature and Scope Of The Problemmentioning

confidence: 99%

Management of Incidental Liver Lesions on CT: A White Paper of the ACR Incidental Findings Committee

Gore

Pickhardt

Mortelé

et al. 2017

Journal of the American College of Radiology

101

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The ACR Committee on Incidental Findings presents recommendations for managing liver lesions that are incidentally detected on CT. These recommendations represent an update from the liver component of the ACR 2010 white paper on managing incidental findings in the pancreas, adrenal glands, kidneys, and liver. The Liver Subcommittee-which included five abdominal radiologists, one hepatologist, and one hepatobiliary surgeon-developed this algorithm. The recommendations draw from published evidence and expert opinion and were finalized by informal iterative consensus. Algorithm branches categorize liver lesions on the basis of patient characteristics and imaging features. They terminate with an assessment of benignity or a specific follow-up recommendation. The algorithm addresses most, but not all, pathologies and clinical scenarios. The goal is to improve the quality of care by providing guidance on how to manage incidentally detected liver lesions.

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Section: Nature and Scope Of The Problemmentioning

confidence: 99%

Management of Incidental Liver Lesions on CT: A White Paper of the ACR Incidental Findings Committee

Gore

Pickhardt

Mortelé

et al. 2017

Journal of the American College of Radiology

101

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“…The superiority of CT compared with intravenous urography (IVU) and ultrasonography (US) has been demonstrated by many clinical trials [4][5][6][7] in which CT had sensitivities of 96%-100%, specificities of 95.5%-100% and accuracies of 96%-98%. Moreover, several previous studies [6,8,9] have shown that 10%-45% of patients presenting with flank pain are affected by extraurinary conditions (the most common disease entities that can mimic renal colic are [10] diverticulitis, adnexal masses and appendicitis).…”

Section: Introductionmentioning

confidence: 98%

“…La superiorità della UHCT nei confronti di urografia endovenosa (IVU) ed ecografia (US) è stata dimostrata da molteplici studi clinici [4][5][6][7], che hanno evidenziato per la TC valori di sensibilità tra 96%-100%, di specificità tra 95,5%-100% e accuratezza tra 96%-98%. Precedenti studi [6,8,9] hanno inoltre dimostrato che nel 10%-45% dei pazienti con dolore al fianco la TC identifica facilmente le patologie extraurinarie (le affezioni che più frequentemente mimano il dolore della colica renale [10] sono: diverticolite, masse annessiali ed appendicite).…”

Section: Introductionunclassified

Low-dose unenhanced CT protocols according to individual body size for evaluating suspected renal colic: cumulative radiation exposures

et al. 2009

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“…When performed at a low level of suspicion and/or weak clinical basis, however, they may detect incidental findings that may lead to unjustified medical evaluations. [8][9][10] We aimed to analyze the pattern of requests and yield of NCCTs in diagnosing OU in the acute setting, and estimated its appropriateness and the associated clinical implications.…”

Section: Introductionmentioning

confidence: 99%

Emergency department non-contrast computed tomography for suspicion of obstructive urolithiasis: Yield and consequences

Savin

Dekalo

Schreter

et al. 2022

CUAJ

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Introduction: We aimed to analyze patterns of referral, yield, and clinical implications of non-contrast computed tomography (NCCT) in the acute evaluation of flank pain suspected as obstructive urolithiasis (OU) in a high-volume emergency department (ED). Methods: The study comprised 506 consecutive NCCTs performed in the ED over four months. Detection rates of OU, incidental, and alternative findings were calculated. Imaging signs suspicious for recent passage of stones were considered positive for OU, while renal stones without signs of obstruction were considered unrelated to the acute presentation. OU, other findings requiring hospitalization, and incidental findings warranting further workup were considered situations in which NCCTs were warranted. Results: NCCTs confirmed an OU diagnosis in 162 (32%) patients and non-clinically significant nephrolithiasis in 125 (25%). They revealed other findings in 108 (21%) patients, including 42 (8%) with clinically significant incidental findings and 26 (5%) with alternative diagnoses requiring hospitalization. NCCTs were entirely negative in 111 (22%) patients. Corroboration of these outcomes, together with overlapping of OU, incidental, and alternative significant findings in some patients resulted in an overall justified NCCT request rate of 44%. Conclusions: The yield of NCCT performed in acute presentations of flank pain suspected as OU is relatively low, and over one-half of the scans are unwarranted. The pattern of requesting NCCT in the ED needs refinement to avoid abuse that may lead to radiation overexposure, psychological burden, physical harm, and financial overload.

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Clinical impact of incidental diagnosis of disease on non-contrast-enhanced helical CT for acute ureteral colic

Cited by 14 publications

References 23 publications

Management of Incidental Liver Lesions on CT: A White Paper of the ACR Incidental Findings Committee

Management of Incidental Liver Lesions on CT: A White Paper of the ACR Incidental Findings Committee

Low-dose unenhanced CT protocols according to individual body size for evaluating suspected renal colic: cumulative radiation exposures

Emergency department non-contrast computed tomography for suspicion of obstructive urolithiasis: Yield and consequences

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