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European Radiology
Published in: European Radiology 6/2017

Open Access 01-06-2017 | Emergency Radiology

High rates of clinically relevant incidental findings by total-body CT scanning in trauma patients; results of the REACT-2 trial

Authors: K. Treskes, S. A. Bos, L. F. M. Beenen, J. C. Sierink, M. J. R. Edwards, B. J. A. Beuker, G. S. R. Muradin, J. Hohmann, J. S. K. Luitse, M. W. Hollmann, M. G. W. Dijkgraaf, J. C. Goslings, on behalf of the REACT-2 study group

Published in: European Radiology | Issue 6/2017

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Abstract

Objectives

To determine whether there is a difference in frequency and clinical relevance of incidental findings detected by total-body computed tomography scanning (TBCT) compared to those by the standard work-up (STWU) with selective computed tomography (CT) scanning.

Methods

Trauma patients from five trauma centres were randomized between April 2011 and January 2014 to TBCT imaging or STWU consisting of conventional imaging with selective CT scanning. Incidental findings were divided into three categories: 1) major finding, may cause mortality; 2) moderate finding, may cause morbidity; and 3) minor finding, hardly relevant. Generalized estimating equations were applied to assess differences in incidental findings.

Results

In total, 1083 patients were enrolled, of which 541 patients (49.9 %) were randomized for TBCT and 542 patients (50.1 %) for STWU. Major findings were detected in 23 patients (4.3 %) in the TBCT group compared to 9 patients (1.7 %) in the STWU group (adjusted rate ratio 2.851; 95%CI 1.337–6.077; p < 0.007). Findings of moderate relevance were detected in 120 patients (22.2 %) in the TBCT group compared to 86 patients (15.9 %) in the STWU group (adjusted rate ratio 1.421; 95%CI 1.088–1.854; p < 0.010).

Conclusions

Compared to selective CT scanning, more patients with clinically relevant incidental findings can be expected by TBCT scanning.

Key points

• Total-body CT scanning in trauma results in 1.5 times more incidental findings.
• Evaluation by TBCT in trauma results in more patients with incidental findings.
• In every category of clinical relevance, TBCT detects more incidental findings.
Appendix
Available only for authorised users
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Metadata
Title
High rates of clinically relevant incidental findings by total-body CT scanning in trauma patients; results of the REACT-2 trial
Authors
K. Treskes
S. A. Bos
L. F. M. Beenen
J. C. Sierink
M. J. R. Edwards
B. J. A. Beuker
G. S. R. Muradin
J. Hohmann
J. S. K. Luitse
M. W. Hollmann
M. G. W. Dijkgraaf
J. C. Goslings
on behalf of the REACT-2 study group
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 6/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4598-6

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