Unindicated multiphase CT scans in non-traumatic abdominal emergencies for women of reproductive age

a significant source of unnecessary exposure

Caterina Giannitto, Mauro Campoleoni, Sara Maccagnoni, Alessio Salvatore Angileri, Maria Carmela Grimaldi, Nino Giannitto, Francesca de Piano, Eleonora Ancona, Pietro Raimondo Biondetti, Andrea Alessandro Esposito

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: 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. Materials and methods: 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. Results: 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. Conclusion: 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.

Original languageEnglish
Pages (from-to)185-190
Number of pages6
JournalRadiologia Medica
Volume123
Issue number3
DOIs
Publication statusPublished - 2018

Fingerprint

Emergencies
Radiation
Uterus
Ovary
Gynecological Examination
Appendicitis
Abdominal Pain
Software

Keywords

  • Computed tomography
  • Emergency
  • Radiation protection
  • Women

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

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 Salvatore; Grimaldi, Maria Carmela; Giannitto, Nino; de Piano, Francesca; Ancona, Eleonora; Biondetti, Pietro Raimondo; Esposito, Andrea Alessandro.

In: Radiologia Medica, Vol. 123, No. 3, 2018, p. 185-190.

Research output: Contribution to journalArticle

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AU - Angileri, Alessio Salvatore

AU - Grimaldi, Maria Carmela

AU - Giannitto, Nino

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AU - Esposito, Andrea Alessandro

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AB - Purpose: 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. Materials and methods: 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. Results: 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. Conclusion: 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.

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