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Ultra-low dose CT abdomen and pelvis for the detection of acute abdominal pathology in the emergency room: initial experience from an academic hospital

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Abstract

Purpose

The aim of this study is to describe our initial experience using ULDCT performed in the emergency room in the evaluation of acute abdominal pathology.

Methods

Data from consecutive patients who underwent ULDCT for assessment of bowel obstruction, free intraperitoneal air, unexplained abdominal pain, or fecal loading for constipation between June 1, 2016 and March 31, 2017 was retrospectively assessed. Demographic data, radiation dose, CT findings, and clinical outcomes including performance of full dose contrast-enhanced CT (CECT), hospitalization, and surgery was collected. Concordance of ULDCT to CECT was calculated.

Results

ULDCT was performed in 325 patients (188 women and 137 men; mean age, 65.1 years). ULDCT detected acute abdominal pathology in 134/325 (41.2%), and in 89/134 (66.4%) it was concordant with the clinical working diagnosis. The average dose length product (DLP) was 101.6 mGy cm (range 51.7–614; median, 82.6). CECT was performed in 44/325 patients (13.5%). In 7/44 (15.9%), CECT identified discordant findings which likely impacted management. A greater proportion of patients were admitted to hospital after a positive ULDCT 99/137 (72.3%), compared to those with a negative study 81/188 (43.1%); p < 0.0001(Chi2, 27.30). Of those admitted to hospital, 11/99 (11.1%) with positive ULDCT had surgery compared to 1/81 (1.2%) with a negative ULDCT; p < 0.008 (Chi2, 6.98).

Conclusion

With its high clinical yield and similar radiation dose, ULDCT appears as a suitable alternative to abdominal radiography for the detection of select acute abdominal pathology in the emergency room.

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Authors and Affiliations

  1. Joint Department of Medical Imaging, Princess Margaret Cancer Centre, University Health Network, Mount Sinai Hospital and Women’s College Hospital, University of Toronto, 610 University Ave, Suite 3-960, Toronto, ON, M5G 2M9, Canada

    Shlomo Gavrielli, Charles Yan, Patrik Rogalla, Reut Anconina & Ur Metser

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  1. Shlomo Gavrielli
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  2. Charles Yan
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  3. Patrik Rogalla
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Correspondence to Ur Metser.

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Gavrielli, S., Yan, C., Rogalla, P. et al. Ultra-low dose CT abdomen and pelvis for the detection of acute abdominal pathology in the emergency room: initial experience from an academic hospital. Emerg Radiol 28, 15–21 (2021). https://doi.org/10.1007/s10140-020-01804-2

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  • DOI: https://doi.org/10.1007/s10140-020-01804-2

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