Incidental findings on whole‐body computed tomography in trauma patients: the current state of incidental findings and the effect of implementation of a feedback system

Abstract

Aim Whole‐body computed tomography (CT) for trauma occasionally reveals significant incidental findings not related to trauma, which require an adequate response. In this study, we examined the current state of incidental findings in trauma patients on whole‐body CT and the effects of the feedback system. Methods The subject sample included trauma patients who underwent whole‐body CT while being examined for trauma during the 2‐year period, with the interpretation of the CT reported by a radiologist. The frequency and recognition of incidental findings and the involved body region were investigated. The state of incidental findings before and after implementation of a radiography report feedback system was also examined. Results During the study period, whole‐body CT revealed incidental findings in 79 of 199 trauma patients (40.1%). The mean age of the 79 patients with incidental findings was 62.8 ± 19.5 years, and the mean injury severity score was 16.6 ± 10.0. No difference was observed in the severity of trauma, age, or length of hospital stay. The incidental findings were related to the liver/gallbladder in 22 patients, kidneys in 17, lungs in 14, and the intracranial area in 13. The recognition rate of incidental findings after the implementation of the feedback system increased from 23.3% to 32.6%. Conclusions Considering that not all incidental findings are accurately recognized, a proper feedback system is required. A feedback system is beneficial and a need to ensure improvement in the recognition of incidental findings.

Incidental thorax imaging findings in abdominal computed tomography: Results of a tertiary center

“…In this study, we investigated the rate of incidental imaging findings detected in chest structures included in ACT images, which was 49.1%, similar to the rate of chest findings found incidentally in trauma patients recently [9]. The most common incidental finding in our patients was atelectatic changes (9.9%).…”

Emergent Comprehensive Imaging of the Major Trauma Patient: A New Paradigm for Improved Clinical Decision-Making

“…Feedback to clinical teams following final reporting can increase the recognition of incidental findings by the ordering physician. 72…”

Incidental CT Findings in the Elderly with Low-Energy Falls: Prevalence and Implications

“…Especially in patients suffering from high-energy trauma, whole-body CT (WBCT) scans are increasingly used and recommended by guidelines due to their real-time detection of acute traumatic injuries (ATI) with high specificity and sensitivity and their widespread availability [ 1 , 2 , 3 , 4 ]. However, besides their associated radiation exposure [ 1 , 2 ], WBCT scans are likely to reveal incidental findings (IF) unrelated to the preceding trauma [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. Incidental findings are defined as recently unknown abnormalities revealed unintentionally in medical examinations.…”

“…Several studies have reported on the prevalence and impact of IFs in predominantly severely injured trauma patients who received WBCT or selective CT scans as initial emergency imaging modality [ 5 , 6 , 8 , 9 , 10 , 18 ]. The prevalence of IFs in different trauma patient populations varies from 30.4% to 75.3% [ 5 , 6 , 8 , 9 , 10 , 12 , 13 , 14 , 15 , 16 , 18 , 19 , 20 , 21 ], with more findings detected by means of WBCT than by selective CT scans [ 10 ]. An amount of 1% to 46.9% of IFs could have an impact on patients’ health and require urgent treatment or further examination [ 5 , 10 , 11 , 17 ].…”