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Findings of Whole-Body CT Screening

Radiologists reviewed written reports of nearly 1200 consecutive screenings performed at one imaging center.

Whole-body computed tomographic (CT) screening is offered at some radiology centers. Supporters believe that whole-body CT screening offers benefit by detecting treatable asymptomatic disease, while detractors point to frequent incidental findings that would trigger expensive and harmful additional investigations. In this study, radiologists from the University of California, San Diego, reviewed written reports of 1192 consecutive whole-body noncontrast CT screenings performed at a stand-alone for-profit imaging center (that had no relationship to the university). Most patients were self-referred; mean age was 54.

Principal findings were as follows:

• 86% of patients had at least one finding (excluding cardiac and coronary calcium findings); the mean number of findings per patient was 2.8.
  
• 42% of patients had noncardiac thoracic findings, mostly pulmonary scars and nodules, vascular calcifications, and mediastinal lymph node abnormalities.
  
• 69% of patients had abdominopelvic findings, mostly vascular calcifications, cysts and nonspecific lesions in the liver, cysts and calcifications in the kidney, prostate enlargement, and uterine fibroids or ovarian cysts.
  
• 60% of patients had spine abnormalities, mostly degenerative changes.
  
• In 37% of reports, the radiologist made follow-up recommendations, usually for additional imaging procedures such as CT with contrast.
  

Comment: The researchers in this study reviewed reports and not the images themselves, and there was no clinical follow-up. Nevertheless, the analysis gives us a snapshot of what whole-body CT screening would likely reveal. For obvious reasons, the benefits and harms of whole-body CT screening should be evaluated rigorously before it becomes routine.

— Allan S. Brett, MD

Published in Journal Watch General Medicine November 18, 2005

Citation(s):

Furtado CD et al. Whole-body CT screening: Spectrum of findings and recommendations in 1192 patients. Radiology 2005 Nov; 237:385-94.

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