Unindicated multiphase CT scans in non-traumatic abdominal emergencies for women of reproductive age: a significant source of unnecessary exposure
Autor: | Caterina Giannitto, Nino Giannitto, Mauro Campoleoni, Pietro Biondetti, Maria Carmela Grimaldi, Andrea Esposito, Sara Maccagnoni, Francesca De Piano, Eleonora Ancona, Alessio Salvatore Angileri |
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Rok vydání: | 2017 |
Předmět: |
Adult
Radiography Abdominal Abdominal pain Uterus Reproductive age Unnecessary Procedures Radiation Dosage Risk Assessment Sensitivity and Specificity Pelvis 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Abdomen medicine Humans Radiology Nuclear Medicine and imaging Retrospective Studies Neuroradiology Evidence-Based Medicine medicine.diagnostic_test business.industry Ultrasound Interventional radiology General Medicine Appendicitis medicine.disease Abdominal Pain Radiation Effects medicine.anatomical_structure 030220 oncology & carcinogenesis Cohort Female Emergencies medicine.symptom Tomography X-Ray Computed Nuclear medicine business |
Zdroj: | La radiologia medica. 123:185-190 |
ISSN: | 1826-6983 0033-8362 |
Popis: | To determine the frequency of unindicated CT phases and the resultant excess of absorbed radiation doses to the uterus and ovaries in women of reproductive age who have undergone CT for non-traumatic abdomino-pelvic emergencies. We reviewed all abdomino-pelvic CT examinations in women of reproductive age (40 years or less), between 1 June 2012 and 31 January 2015. We evaluated the appropriateness of each CT phase on the basis of clinical indications, according to ACR appropriateness criteria and evidence-based data from the literature. The doses to uterus and ovaries for each phase were calculated with the CTEXPO software, taking into consideration the size-specific dose estimate (SSDE) after measuring the size of every single patient. The final cohort was composed of 76 female patients with an average age of 30 (from 19 to 40 years). In total, 197 CT phases were performed with an average of 2.6 phases per patient. Out of these, 93 (47%) were unindicated with an average of 1.2 inappropriate phases per patient. Unindicated scans were most frequent for appendicitis and unlocalized abdominal pain. The excesses of mean radiation doses to the uterus and ovaries due to unindicated phases were, respectively, of 38 and 33 mSv per patient. In our experience, unindicated additional CT phases were numerous with a significant excess radiation dose without an associated clinical benefit. This excess of radiation could have been avoided by widespread adoption of the ACR appropriateness criteria and evidence-based data from the literature. |
Databáze: | OpenAIRE |
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