Is utilisation of computed tomography justified in clinical practice? Part I: Application in the emergency department

Singapore Medical Journal

Volumn 51, Issue 3, 2010, Pages 200-206

  Sun, Z ^a   Ng, K H ^b   Vijayananthan, A ^b  

^a CURTIN UNIVERSITY   (Australia)

^b UNIVERSITY OF MALAYA   (Malaysia)

Author keywords

Computed tomography; Emergency department; Radiation dose; Radiation risk; Trauma

Indexed keywords

ABDOMINAL INJURY; CANCER RISK; CLINICAL PRACTICE; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; COMPUTER ASSISTED TOMOGRAPHY; DIAGNOSTIC ACCURACY; DIAGNOSTIC VALUE; EMERGENCY WARD; HEAD INJURY; HEADACHE; HUMAN; IMAGE DISPLAY; IMAGE RECONSTRUCTION; IMAGING SYSTEM; MEDICAL DECISION MAKING; MULTIDETECTOR COMPUTED TOMOGRAPHY; NUCLEAR MAGNETIC RESONANCE IMAGING; PELVIS INJURY; PHYSICIAN ATTITUDE; RADIATION EXPOSURE; REVIEW; RISK ASSESSMENT; RISK BENEFIT ANALYSIS; THORAX INJURY; THREE DIMENSIONAL IMAGING; WHOLE BODY IMAGING;

DOSE-RESPONSE RELATIONSHIP, RADIATION; EMERGENCY SERVICE, HOSPITAL; HUMANS; PHYSICIAN'S PRACTICE PATTERNS; RISK ASSESSMENT; RISK FACTORS; TOMOGRAPHY, X-RAY COMPUTED; WHOLE BODY IMAGING; WOUNDS AND INJURIES;

EID: 77951885760     PISSN: 00375675     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (53)

1. United Nations Scientific Committee on the Effects of Atomic Radiation report to the general assembly, Vol II, Annex D: Medical radiation exposures. New York: United Nations, 2006.
2. Verdun FR, Gutierrez D, Vader JP, et al. CT radiation dose in children: a survey to establish age-based diagnostic reference levels in Switzerland. Eur Radiol 2008; 18:1980-6.
3. McCollough CH, Zink FE. Performance evaluation of a multi- slice CT system. Med Phys 1999; 26:2223-30.
4. Rybicki FJ, Otero HJ, Steigner ML, et al. Initial evaluation of coronary images from 320-detector row computed tomography. Int J Cardiovasc Imaging 2008; 24:535-46.
5. Altes TA. Multislice computed tomographic scanning: technological innovations bring new indications in pediatric chest CT. Pediatr Ann 2002; 31:671-5.
6. Salamipour H, Jimenez RM, Brec SL, et al. Multidetector row CT in pediatric musculoskeletal imaging. Pediatr Radiol 2005; 35:555-64.
7. Brenner D, Ellison C, Hall E, Berdon W. Estimated risks of radiation-induced fatal cancer from pediatric CT. Am J Roentgenol 2001; 176:289-96.
8. Brenner DJ, Hall EJ. Computed tomography - an increasing source of radiation exposure. N Engl J Med 2007; 357:2277-84.
9. IMV 2006 CT Market Summary Report. Des Plaines: IMV Medical Information Division, 2006.
10. Heyer CM, Hansmann J, Peters SA, Lemburg SP. Paediatrician awareness of radiation dose and inherent risks in chest imaging studies - A questionnaire study. Eur J Radiol 2009. In press.
11. Fazel R, Krumholz HM, Wang Y, et al. Exposure to low-dose ionizing radiation from medical imaging procedures. N Engl J Med 2009; 361:849-57.
12. McCollough CH, Guimaraes L, Fletcher JG. In defense of body CT. Am J Roentgenol 2009; 193:28-39.
13. Committee to Access Health Risks from Exposure to Low Level of Ionizing Radiation, National Research Council, Health risks from exposure to low level of ionizing radiation. BEIR VII Phase 2. Washington: National Academies Press, 2006.
14. Mettler FA Jr, Huda W, Yoshizumi TT, Mahesh M. Effective doses in radiology and diagnostic nuclear medicine: a catalog. Radiology 2008; 248:254-63.
15. International Commission on Radiological Protection (2007) Recommendations of the ICRP, publication 103.
16. Smith-Bindman R, Lipson J, Marcus R, et al. Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med 2009; 169:2078-86.
17. Broder J, Bowen J, Lohr J, Babcock A, Yoon J. Cumulative CT exposures in emergency department patients evaluated for suspected renal colic. J Emerg Med 2007; 33:161-8.
18. Amis ES Jr, Butler PF, Applegate KE, et al. American College of Radiology white paper on radiation dose in medicine. J Am Coll Radiol 2007; 4:272-84.
19. Broder J, Warshauer DM. Increasing utilization of computed tomography in the adult emergency department, 2000-2005. Emerg Radiol 2006; 13:25-30.
20. Nawar EW, Niska RW, Xu J. National Hospital Ambulatory Medical Care Survey: 2005 Emergency Department Summary. Advance data from vital and health statistics; no. 386. Hyattsville: National Center for Health Statistics, 2007.
21. Medina LS, D'Souza B, Vasconcellos E. Adults and children with headache: evidence-based diagnostic evaluation. Neuroimaging Clin N Am 2003; 13:225-35.
22. Grosskreutz ST, Osborn RE, Sanchez RM. Computed tomography of the brain in the evaluation of the headache patient. Mil Med 1991; 156:137-40.
23. Weingarten S, Kleinman M, Elperin L, Larson EB. The effectiveness of cerebral imaging in the diagnosis of chronic headache. Arch Intern Med 1992; 152:2457-62.
24. Jordan JE. Expert Panel on Neurologic Imaging. Headache. Am J Neuroradiol 2007; 28:1824-6.
25. Jordan YJ, Lightfoote JB, Jordon JE. Computed tomography imaging in the management of headache in the emergency department: cost efficacy and policy implications. J Natl Med Assoc 2009; 101:331-5.
26. Jamshidi S, Kandiah PA, Singhal AB, et al. Clinical predictors of significant findings on head computed tomographic angiography. J Emerg Med 2009. In Press.
27. Wiest PW, Locken JA, Heintz PH, Mettler FA Jr. CT scanning: a major source of radiation exposure. Semin Ultrasound CT MR 2002; 23:402-10.
28. Jaffe TA, Gaca AM, Delaney S, et al. Radiation doses from small- bowel follow-through and abdominopelvic MDCT in Crohn's disease. Am J Roentgenol 2007; 189:1015-22.
29. Griffey RT, Sodickson A. Cumulative radiation exposure and cancer risk estimates in emergency department patients undergoing repeat or multiple CT. Am J Roentgenol 2009; 192:887-92.
30. Sodickson A, Baeyens PF, Andriole KP, et al. Recurrent CT, cumulative radiation exposure, and associated radiation-induced cancer risks from CT of adults. Radiology 2009; 251:175-84.
31. Hayward R. VOMIT (victims of modern imaging technology) - an acronym for our times. BMJ 2003; 326:1273.
32. Heyer CM, Rduch GJ, Wick M, et al. [Evaluation of multiple trauma victims with 16-row multidetector computed tomography (MDCT): a time analysis]. Rofo 2005; 177:1677-82. German.
33. Gralla J, Spycher F, Pignolet C, et al. Evaluation of a 16-MDCT scanner in an emergency department: initial clinical experience and workflow analysis. Am J Roentgenol 2005; 185:232-8.
34. Brown CV, Antevil JL, Sise MJ, Sack DI. Spiral computed tomography for the diagnosis of cervical, thoracic, and lumbar spine fractures: its time has come. J Trauma 2005; 58:890-6.
35. Rhee PM, Bridgeman A, Acosta JA, et al. Lumbar fractures in adult blunt trauma: axial and single-slice helical abdominal and pelvic computed tomographic scans versus portable plain films. J Trauma 2002; 53:663-7.
36. Self ML, Blake AM, Whitley M, Nadalo L, Dunn E. The benefit of routine thoracic, abdominal, and pelvic computed tomography to evaluate trauma patients with closed head injury. Am J Surg 2003; 186:609-14.
37. Pal JD, Victorino GP. Defining the role of computed tomography in blunt abdominal trauma: use in the hemodynamically stable patient with a depressed level of consciousness. Arch Surg 2002; 137:1029-33.
38. Poletti PA, Mirvis SE, Shanmuganathan K, et al. Blunt abdominal trauma patients: can organ injury be excluded without performing computed tomography? J Trauma 2004; 57:1072-81.
39. Schurink GW, Bode PJ, van Luijt PA, van Vugt AB. The value of physical examination in the diagnosis of patients with blunt abdominal trauma: a retrospective study. Injury 1997; 28:261-5.
40. Mackerise RC, Tiwary AD, Shackford SR, Hoyt DB. Intra- abdominal injury following blunt abdominal trauma. Identifying the high-risk patient using objective risk factors. Arch Surg 1989; 124:809-13.
41. Hauser H, Bohndorf K. [Radiologic emergency management in multiple trauma cases]. Radiologe 1998; 38:637-44. German.
42. Nunez DB Jr, Ledbetter MS, Farrell L. Dedicated CT scanner in an emergency department: quantification of factors that contribute to lack of use. Am J Roentgenol 2002; 179:859-62.
43. Novelline RA, Rhea JT, Rao PM, Stuk JL. Helical CT in emergency radiology. Radiology 1999; 213:321-39.
44. Kuettner A, Trabold T, Schroeder S, et al. Noninvasive detection of coronary lesions using 16-detector multislice spiral computed tomography technology: initial clinical results. J Am Coll Cardiol 2004; 44:1230-7.
45. Raff GL, Gallagher MJ, O'Neill WW, Goldstein JA. Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J Am Coll Cardiol 2005, 46:552-7.
46. Langner S, Fleck S, Kirsch M, Petrik M, Hosten N. Whole-Body CT trauma imaging with adapted and optimized CT angiography of the craniocervical vessels: do we need an extra screening examination? Am J Neuroradiol 2008; 29:1902-7.
47. Salim A, Sangthong B, Martin M, et al. Whole body imaging in blunt multisystem trauma patients without obvious signs of injury: results of a prospective study. Arch Surg 2006; 141:468-75.
48. Wurmb TE, Fruhwald P, Hopfner W, et al. Whole-body multislice computed tomography as the first line diagnostic tool in patients with multiple injuries: the focus on time. J Trauma 2009; 66:658-65.
49. Rieger M, Czermak B, El AttaI R, et al. Initial clinical experience with a 64-MDCT whole-body scanner in an emergency department: better time management and diagnostic quality? J Trauma 2009; 66:648-57.
50. Huber-Wagner S, Lefering R, Qvick LM, et al; Working Group on Polytrauma of the German Trauma Society. Effect of whole- body CT during trauma resuscitation on survival: a retrospective, multicentre study. Lancet 2009; 373:1455-61.
51. Fanucci E, Fiaschetti V, Rotili A, Floris R, Simonetti G. Whole body 16-row multislice CT in emergency room: effects of different protocols on scanning time, image quality and radiation exposure. Emerg Radiol 2007; 13:251-7.
52. Ptak T, Rhea JT, Novelline RA. Radiation dose is reduced with a single-pass whole-body multi-detector row CT trauma protocol compared with a conventional segmented method: initial experience. Radiology 2003; 229:902-5.
53. Brenner DJ, Elliston CD. Estimated radiation risks potentially associated with full-body CT screening. Radiology 2004; 232:735-8.