La radiologia medica

, Volume 123, Issue 3, pp 185–190 | Cite as

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



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.


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.


Emergency Computed tomography Women Radiation protection 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Italian Society of Medical Radiology 2017

Authors and Affiliations

  • Caterina Giannitto
    • 1
  • Mauro Campoleoni
    • 2
  • Sara Maccagnoni
    • 1
  • Alessio Salvatore Angileri
    • 1
  • Maria Carmela Grimaldi
    • 1
  • Nino Giannitto
    • 3
  • Francesca De Piano
    • 1
  • Eleonora Ancona
    • 1
  • Pietro Raimondo Biondetti
    • 4
  • Andrea Alessandro Esposito
    • 4
  1. 1.Postgraduation School in RadiodiagnosticsUniversità degli Studi di MilanoMilanItaly
  2. 2.Medical Phisic UnitFoundation IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
  3. 3.Università di MessinaMessinaItaly
  4. 4.Department of RadiologyFoundation IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly

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