Diagnostic accuracy of ultra-low-dose chest computed tomography in an emergency department.
Aged
Confidence Intervals
Emergency Service, Hospital
Feasibility Studies
Female
Humans
Male
Pleural Effusion
/ diagnostic imaging
Pneumonia
/ diagnostic imaging
Pneumothorax
/ diagnostic imaging
Prospective Studies
Pulmonary Edema
/ diagnostic imaging
Radiation Dosage
Radiation Exposure
Radiography, Thoracic
/ methods
Reference Standards
Sensitivity and Specificity
Tomography, X-Ray Computed
/ methods
Diagnostic accuracy, ultra-low-dose chest CT, pneumonia, pneumothorax, pleural effusion, cardiogenic pulmonary edema
Journal
Acta radiologica (Stockholm, Sweden : 1987)
ISSN: 1600-0455
Titre abrégé: Acta Radiol
Pays: England
ID NLM: 8706123
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
pubmed:
6
3
2021
medline:
14
1
2022
entrez:
5
3
2021
Statut:
ppublish
Résumé
This study examined whether ultra-low-dose chest computed tomography (ULD-CT) could improve detection of acute chest conditions. To determine (i) whether diagnostic accuracy of ULD-CT is superior to supine chest X-ray (sCXR) for acute chest conditions and (ii) the feasibility of ULD-CT in an emergency department. From 1 February to 31 July 2019, 91 non-traumatic patients from the Emergency Department were prospectively enrolled in the study if they received an sCXR. An ULD-CT and a non-contrast chest CT (NCCT) scan were then performed. Three radiologists assessed the sCXR and ULD-CT examinations for cardiogenic pulmonary edema, pneumonia, pneumothorax, and pleural effusion. Resources and effort were compared for sCXR and ULD-CT to evaluate feasibility. Diagnostic accuracy was calculated for sCXR and ULD-CT using NCCT as the reference standard. The mean effective dose of ULD-CT was 0.05±0.01 mSv. For pleural effusion and cardiogenic pulmonary edema, no difference in diagnostic accuracy between ULD-CT and sCXR was observed. For pneumonia and pneumothorax, sensitivities were 100% (95% confidence interval [CI] 69-100) and 50% (95% CI 7-93) for ULD-CT and 60% (95% CI 26-88) and 0% (95% CI 0-0) for sCXR, respectively. Median examination time was 10 min for ULD-CT vs. 5 min for sCXR ( ULD-CT seems equal or better in detecting acute chest conditions compared to sCXR. However, ULD-CT examinations demand more effort and resources.
Sections du résumé
BACKGROUND
BACKGROUND
This study examined whether ultra-low-dose chest computed tomography (ULD-CT) could improve detection of acute chest conditions.
PURPOSE
OBJECTIVE
To determine (i) whether diagnostic accuracy of ULD-CT is superior to supine chest X-ray (sCXR) for acute chest conditions and (ii) the feasibility of ULD-CT in an emergency department.
MATERIAL AND METHODS
METHODS
From 1 February to 31 July 2019, 91 non-traumatic patients from the Emergency Department were prospectively enrolled in the study if they received an sCXR. An ULD-CT and a non-contrast chest CT (NCCT) scan were then performed. Three radiologists assessed the sCXR and ULD-CT examinations for cardiogenic pulmonary edema, pneumonia, pneumothorax, and pleural effusion. Resources and effort were compared for sCXR and ULD-CT to evaluate feasibility. Diagnostic accuracy was calculated for sCXR and ULD-CT using NCCT as the reference standard.
RESULTS
RESULTS
The mean effective dose of ULD-CT was 0.05±0.01 mSv. For pleural effusion and cardiogenic pulmonary edema, no difference in diagnostic accuracy between ULD-CT and sCXR was observed. For pneumonia and pneumothorax, sensitivities were 100% (95% confidence interval [CI] 69-100) and 50% (95% CI 7-93) for ULD-CT and 60% (95% CI 26-88) and 0% (95% CI 0-0) for sCXR, respectively. Median examination time was 10 min for ULD-CT vs. 5 min for sCXR (
CONCLUSION
CONCLUSIONS
ULD-CT seems equal or better in detecting acute chest conditions compared to sCXR. However, ULD-CT examinations demand more effort and resources.
Identifiants
pubmed: 33663246
doi: 10.1177/0284185121995804
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM