Role of computed tomography at a cancer center emergency department

To evaluate the imaging methods used at the emergency department (ED) of a cancer center, with emphasis on computed tomography (CT). A descriptive, retrospective, single-center study was conducted by reviewing imaging exams and medical records, after approval of the institution’s Ethics Review Board...

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Bibliographic Details
Published in:	Emergency radiology Vol. 24; no. 2; pp. 113 - 117
Main Authors:	Otoni, Jessyca Couto, Noschang, Julia, Okamoto, Thábata Yaedu, Vieira, Diego Rosseman, Petry, Michel Souto Mayor, de Araujo Ramos, Lucas, Barbosa, Paula Nicole Vieira Pinto, Bitencourt, Almir Galvão Vieira, Chojniak, Rubens
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-04-2017 Springer Nature B.V
Subjects:	Adolescent Adult Aged Aged, 80 and over Cancer Care Facilities Child Child, Preschool Emergency Medicine Emergency Service, Hospital Female Humans Imaging Infant Infant, Newborn Male Medicine Medicine & Public Health Middle Aged Neoplasms - diagnostic imaging Original Article Radiology Retrospective Studies Tomography, X-Ray Computed Diagnostic imaging Emergency department Computed tomography Cancer
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Summary:	To evaluate the imaging methods used at the emergency department (ED) of a cancer center, with emphasis on computed tomography (CT). A descriptive, retrospective, single-center study was conducted by reviewing imaging exams and medical records, after approval of the institution’s Ethics Review Board. The demographic data, cancer history, and imaging exam requested were evaluated for all patients and the indications and results of head, chest, and abdominopelvic CT scans were also evaluated. During the study period, there were 8710 visits to the ED, and 5999 imaging studies were requested in 3788 patients (43.5 % of total of visits). One thousand eight hundred twenty-nine CT exams were used in 1121 visits (12.9 % of total of visits). The mean age of patients was 57.7 years and most patients (93.2 %) had a known primary tumor. The most common indications for abdominopelvic CT were non-oncologic emergencies (26.7 %) and postoperative complications (19.2 %), and the results were negative in 36.6 %, positive for clinical suspicion in 49.0 %, and incidental positive in 14.5 %. The most frequent indication for chest CT was suspected pulmonary embolism (34.4 %); however, only 11.1 % confirmed the diagnosis. The results of head TC were negative in 72.9 % and the indications that had more positive findings were suspected metastasis (32.1 %) and focal neurological sign/altered level of consciousness (24.5 %). CT plays an important role in driving the cancer patients visiting the ED. However, the high rate of negative or discordant results causes a concern for the inadvertent and excessive use of this imaging modality.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1070-3004 1438-1435
DOI:	10.1007/s10140-016-1449-3