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

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; REACT-2 Study Grp

doi:10.1007/s00330-016-4598-6

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

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, REACT-2 Study Grp

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

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.

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.

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).

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

aEuro cent Total-body CT scanning in trauma results in 1.5 times more incidental findings.

aEuro cent Evaluation by TBCT in trauma results in more patients with incidental findings.

aEuro cent In every category of clinical relevance, TBCT detects more incidental findings.

Original language	English
Pages (from-to)	2451-2462
Number of pages	12
Journal	European Radiology
Volume	27
Issue number	6
DOIs	https://doi.org/10.1007/s00330-016-4598-6
Publication status	Published - Jun-2017

Keywords

Total-body CT
Incidental findings
Multiple trauma
Wounds and injuries
Multidetector computed tomography
SCANS
PREVALENCE
CARE

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Treskes, K., Bos, S. A., Beenen, L. F. M., Sierink, J. C., Edwards, M. J. R., Beuker, B. J. A., Muradin, G. S. R., Hohmann, J., Luitse, J. S. K., Hollmann, M. W., Dijkgraaf, M. G. W., Goslings, J. C., & REACT-2 Study Grp (2017). High rates of clinically relevant incidental findings by total-body CT scanning in trauma patients; results of the REACT-2 trial. European Radiology, 27(6), 2451-2462. https://doi.org/10.1007/s00330-016-4598-6

Treskes, K. ; Bos, S. A. ; Beenen, L. F. M. ; Sierink, J. C. ; Edwards, M. J. R. ; Beuker, B. J. A. ; Muradin, G. S. R. ; Hohmann, J. ; Luitse, J. S. K. ; Hollmann, M. W. ; Dijkgraaf, M. G. W. ; Goslings, J. C. ; REACT-2 Study Grp. / High rates of clinically relevant incidental findings by total-body CT scanning in trauma patients; results of the REACT-2 trial. In: European Radiology. 2017 ; Vol. 27, No. 6. pp. 2451-2462.

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

abstract = "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.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.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).Compared to selective CT scanning, more patients with clinically relevant incidental findings can be expected by TBCT scanning.aEuro cent Total-body CT scanning in trauma results in 1.5 times more incidental findings.aEuro cent Evaluation by TBCT in trauma results in more patients with incidental findings.aEuro cent In every category of clinical relevance, TBCT detects more incidental findings.",

keywords = "Total-body CT, Incidental findings, Multiple trauma, Wounds and injuries, Multidetector computed tomography, SCANS, PREVALENCE, CARE",

author = "K. Treskes and Bos, {S. A.} and Beenen, {L. F. M.} and Sierink, {J. C.} and Edwards, {M. J. R.} and Beuker, {B. J. A.} and Muradin, {G. S. R.} and J. Hohmann and Luitse, {J. S. K.} and Hollmann, {M. W.} and Dijkgraaf, {M. G. W.} and Goslings, {J. C.} and {REACT-2 Study Grp}",

year = "2017",

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doi = "10.1007/s00330-016-4598-6",

language = "English",

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journal = "European Radiology",

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Treskes, K, Bos, SA, Beenen, LFM, Sierink, JC, Edwards, MJR, Beuker, BJA, Muradin, GSR, Hohmann, J, Luitse, JSK, Hollmann, MW, Dijkgraaf, MGW, Goslings, JC & REACT-2 Study Grp 2017, 'High rates of clinically relevant incidental findings by total-body CT scanning in trauma patients; results of the REACT-2 trial', European Radiology, vol. 27, no. 6, pp. 2451-2462. https://doi.org/10.1007/s00330-016-4598-6

High rates of clinically relevant incidental findings by total-body CT scanning in trauma patients; results of the REACT-2 trial. / Treskes, K.; Bos, S. A.; Beenen, L. F. M.; Sierink, J. C.; Edwards, M. J. R.; Beuker, B. J. A.; Muradin, G. S. R.; Hohmann, J.; Luitse, J. S. K.; Hollmann, M. W.; Dijkgraaf, M. G. W.; Goslings, J. C.; REACT-2 Study Grp.

In: European Radiology, Vol. 27, No. 6, 06.2017, p. 2451-2462.

Research output: Contribution to journal › Article › Academic › peer-review

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T1 - High rates of clinically relevant incidental findings by total-body CT scanning in trauma patients; results of the REACT-2 trial

AU - Treskes, K.

AU - Bos, S. A.

AU - Beenen, L. F. M.

AU - Sierink, J. C.

AU - Edwards, M. J. R.

AU - Beuker, B. J. A.

AU - Muradin, G. S. R.

AU - Hohmann, J.

AU - Luitse, J. S. K.

AU - Hollmann, M. W.

AU - Dijkgraaf, M. G. W.

AU - Goslings, J. C.

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N2 - 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.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.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).Compared to selective CT scanning, more patients with clinically relevant incidental findings can be expected by TBCT scanning.aEuro cent Total-body CT scanning in trauma results in 1.5 times more incidental findings.aEuro cent Evaluation by TBCT in trauma results in more patients with incidental findings.aEuro cent In every category of clinical relevance, TBCT detects more incidental findings.

AB - 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.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.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).Compared to selective CT scanning, more patients with clinically relevant incidental findings can be expected by TBCT scanning.aEuro cent Total-body CT scanning in trauma results in 1.5 times more incidental findings.aEuro cent Evaluation by TBCT in trauma results in more patients with incidental findings.aEuro cent In every category of clinical relevance, TBCT detects more incidental findings.

KW - Total-body CT

KW - Incidental findings

KW - Multiple trauma

KW - Wounds and injuries

KW - Multidetector computed tomography

KW - SCANS

KW - PREVALENCE

KW - CARE

U2 - 10.1007/s00330-016-4598-6

DO - 10.1007/s00330-016-4598-6

M3 - Article

VL - 27

SP - 2451

EP - 2462

JO - European Radiology

JF - European Radiology

SN - 0938-7994

IS - 6

ER -