Annals of Emergency Medicine
Volume 56, Issue 2 , Pages 126-134 , August 2010

Prospective Double-Blinded Study of Abdominal-Pelvic Computed Tomography Guided by the Region of Tenderness: Estimation of Detection of Acute Pathology and Radiation Exposure Reduction

Presented as an abstract at the Society for Academic Emergency Medicine annual meeting, May 2009, New Orleans, LA.

  • Joshua S. Broder, MD

      Affiliations

    • Department of Surgery, Division of Emergency Medicine, Duke University Medical Center, Durham, NC
    • Corresponding Author InformationAddress for correspondence: Joshua S. Broder, MD, Box 3096, Duke University Medical Center, Durham, NC 27710; 919-684-5537, fax 919-681-8521
    • ,
  • Caroline L. Hollingsworth, MD

      Affiliations

    • Department of Radiology, Duke University Medical Center, Durham, NC
    • ,
  • Chad M. Miller, MD

      Affiliations

    • Department of Radiology, Duke University Medical Center, Durham, NC
    • ,
  • Jennifer L. Meyer, MD

      Affiliations

    • Department of Surgery, Division of Emergency Medicine, Duke University Medical Center, Durham, NC
    • ,
  • Erik K. Paulson, MD

      Affiliations

    • Department of Radiology, Duke University Medical Center, Durham, NC

Received 21 May 2009 ,Revised 15 October 2009 ,Accepted 20 November 2009.

References 

  1. Broder J, Fordham LA, Warshauer DM. Increasing utilization of computed tomography in the pediatric emergency department, 2000-2006. Emerg Radiol. 2007;14:227–232
  2. Broder J, Warshauer DM. Increasing utilization of computed tomography in the adult emergency department, 2000-2005. Emerg Radiol. 2006;13:25–30
  3. Brenner DJ, Hall EJ. Computed tomography: an increasing source of radiation exposure. N Engl J Med. 2007;357:2277–2284
  4. Tsapaki V, Aldrich JE, Sharma R, et al. Dose reduction in CT while maintaining diagnostic confidence: diagnostic reference levels at routine head, chest, and abdominal CT—IAEA-coordinated research project. Radiology. 2006;240:828–834
  5. Gupta AK, Nelson RC, Johnson GA, et al. Optimization of eight-element multi-detector row helical CT technology for evaluation of the abdomen. Radiology. 2003;227:739–745
  6. Fefferman NR, Roche KJ, Pinkney LP, et al. Suspected appendicitis in children: focused CT technique for evaluation. Radiology. 2001;220:691–695
  7. Gamanagatti S, Vashisht S, Kapoor A, et al. Comparison of graded compression ultrasonography and unenhanced spiral computed tomography in the diagnosis of acute appendicitis. Singapore Med J. 2007;48:80–87
  8. Rao PM, Rhea JT, Novelline RA, et al. Helical CT technique for the diagnosis of appendicitis: prospective evaluation of a focused appendix CT examination. Radiology. 1997;202:139–144
  9. van der Molen AJ, Geleijns J. Overranging in multisection CT: quantification and relative contribution to dose—comparison of four 16-section CT scanners. Radiology. 2007;242:208–216
  10. McCollough CH. CT dose: how to measure, how to reduce. Health Phys. 2008;95:508–517
  11. Eypasch E, Lefering R, Kum CK, et al. Probability of adverse events that have not yet occurred: a statistical reminder. BMJ. 1995;311:619–620

 Supervising editor: Allan B. Wolfson, MD

 Author contributions: JSB conceived the study and designed the trial. JSB and JLM supervised the conduct of the trial and data collection. JLM transcribed data forms and recorded sticker locations in a blinded fashion. CLH and EKP interpreted CT, blinded to clinical information and sticker locations. JSB managed and analyzed the data. JSB drafted the article, and all authors contributed substantially to its revision. CMM provided technical advice on radiation exposures and CT protocols. JSB takes responsibility for the paper as a whole.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. Beekley Corporation provided the skin surface adhesive markers used in this study free of charge.

 Publication date: Available online January 20, 2010.

 Reprints not available from the authors.

 Please see page 127 for the Editor's Capsule Summary of this article.

PII: S0196-0644(09)01797-1

doi: 10.1016/j.annemergmed.2009.11.023

Annals of Emergency Medicine
Volume 56, Issue 2 , Pages 126-134 , August 2010

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