Whole-Body CT Screening: Spectrum of Findings and Recommendations in 1192 Patients

Abstract

To retrospectively determine the frequency and spectrum of findings and recommendations reported with whole-body computed tomographic (CT) screening at a community screening center. This HIPAA-compliant study received institutional review board approval, with waiver of informed consent. The radiologic reports of 1192 consecutive patients who underwent whole-body CT screening of the chest, abdomen, and pelvis at an outpatient imaging center from January to June 2000 were reviewed. Scans were obtained with electron-beam CT without oral or intravenous contrast material. Reported imaging findings and recommendations were retrospectively tabulated and assigned scores. Descriptive statistics were used (means, standard deviations, and percentages); comparisons between subgroups were performed with univariate analysis of variance and chi(2) or Fisher exact tests. Screening was performed in 1192 patients (mean age, 54 years). Sixty-five percent (774 of 1192) were men and 35% (418 of 1192) were women. Nine hundred three (76%) of 1192 patients were self referred, and 1030 (86%) of 1192 subjects had at least one abnormal finding described in the whole-body CT screening report. There were a total of 3361 findings, with a mean of 2.8 per patient. Findings were described most frequently in the spine (1065 [32%] of 3361), abdominal blood vessels (561 [17%] of 3361), lungs (461 [14%] of 3361), kidneys (353 [11%] of 3361), and liver (183 [5%] of 3361). Four hundred forty-five (37%) patients received at least one recommendation for further evaluation. The most common recommendations were for additional imaging of the lungs or the kidneys. With whole-body CT screening, findings were detected in a large number of subjects, and most findings were benign by description and required no further evaluation. Thirty-seven percent of patients had findings that elicited recommendations for additional evaluation, but further research is required to determine the clinical importance of these findings and the effect on patient care.