CT Interpretation Research Articles

CT of the head for acute stroke: Diagnostic performance of a tablet computer prior to intravenous thrombolysis.

The authors propose that tablet computers could benefit patients with acute stroke in the remote care setting, where time to and accuracy of CT interpretation greatly influences patient outcome. One hundred and fifty consecutive patients who presented to the Emergency Department of a tertiary referral neurosciences centre within a time window suitable for intravenous thrombolytic therapy were included. Images were wirelessly transmitted to a tablet computer (iPad 3rd Generation, model=A1430, Apple, Cupertino, CA) and were reviewed by radiologists with three levels of experience for signs of intracranial haemorrhage, large vessel occlusion and parenchymal infarction. Reference standard interpretation was performed by two neuroradiologists using a diagnostic monochrome display. Consensus neuroradiologist review on the tablet display found and correctly classified all of the 23 cases of intracranial haemorrhage including 21 cases of parenchymal haematoma, two cases of petechial haemorrhage and one patient with an acute subdural haematoma. Less experienced readers missed cases of petechial and subdural haematomas. There was excellent agreement between the tablet and diagnostic monochrome display in cases with no infarct or extensive parenchymal infarction. Tablet computers can be used to facilitate rapid preliminary CT interpretation in patients with acute stroke in the remote setting.

Abstract 21: Can Telemedicine Replace an On-board Vascular Neurologist in Deciding about Tissue Plasminogen Activator Treatment? A Pre-Specified Substudy of the BEST-MSU Study

Background: Faster treatment with tPA may be achieved by optimizing prehospital triage with mobile stroke units (MSUs). The Benefits of Stroke Treatment Delivered Using a Mobile Stroke Unit (BEST-MSU) study is a prospective comparative effectiveness trial of outcomes in patients randomized to MSU or standard management (SM). Purpose: To evaluate the inter-rater agreement for tPA eligibility between a telemedicine vascular neurologist (TM-VN) and the onboard vascular neurologist (OB-VN) in acute stroke patients seen on the MSU. Methods: Cluster randomization of MSU and SM weeks started on August 18, 2014. On scene, both the TM-VN and OB-VN evaluated the patient and independently documented their tPA treatment decision, NIHSS and CT interpretation. Agreement was determined using Cohen’s kappa (K) statistic. TM related technical failures that impeded remote assessment were recorded. Results: The remote TM-VN evaluated 173 patients. In 4 (2%) cases the TM-VN was not able to make a decision about tPA because of technical difficulties ( 1 case due to TM camera failure and 3 cases due to poor connectivity). The TM-VN agreed with the OB-VN on 88% of evaluations, with a K of 0.73 representing substantial agreement. Baseline NIHSS correlation between the TM-VN and OB-VN was 0.88. Agreement about ICH on CTH was a near-perfect K of 0.97. Conclusions: We conclude from these results that remote VN assessment of stroke patients in the MSU via TM is clinically and technologically feasible, reliable and accurate. TM assessment of CTH and NIHSS was also comparable to the OB evaluation. These findings will allow either OB-VN or TM-VN assessment for the remainder of the study.

Abstract TP390: Continuous Quality Improvement Implementation Across a Large Stroke Network of Affiliated Rural Hospitals Demonstrates Improved Care

Background and Purpose: Currently, the stroke care network includes 28 affiliate hospitals. One of the network missions is to improve quality of care through an evidence-based, standardized approach. In 2014, a formalized continuous quality improvement process began. Methods: Each affiliate receives quality education and utilizes a data report to collect and submit monthly stroke data elements quarterly. Data were compared for system analysis. Results: 18 of 24 (75%) affiliates submitted data in 2014, compared to 23 of 26 (88%) in 2015. For STK[PM]-7: dysphagia screening, 42% of the affiliates submitted data in 2014, compared to 73% in 2015. Out of the hospitals submitting inpatient data for both years, the average for all appropriate measures was 84% in 2014, compared to 88% in 2015. Of these, 27% (4/15) improved, 60% (9/15) remained the same and 13% (2/15) worsened on these inpatient measures. For CT interpretation time ( < 45 minutes), the average time was 50 minutes in 2014, and 52 minutes in 2015. 55% (6/11) improved on the CT interpretation time and 45% (5/11) worsened. For Door to Needle time ( < 60 minutes), the average time was 89 minutes in 2014, and 65 minutes in 2015. 70% (7/10) improved on the Door to Needle time and 30% (3/10) worsened. Conclusions: The network showed substantial improvement with the CQI program in: data submission rates, CT interpretation time, and Door to Needle time. Additionally, for inpatient measures, 87% of affiliates who submitted data for both years improved or remained the same. This is a great success overall. We believe this reflects focused improvement efforts at individual affiliates and network-wide. Areas for focus in the next year were determined: Door to Needle and CT interpretation times, STK-4, STK[PM]-7 and quality of abstraction.

4D-CT for Detection of Parathyroid Adenomas and Hyperplasia: State of the Art Imaging

Radiologic localization of parathyroid lesions is essential for the surgical treatment of primary hyperparathyroidism. In recent years, multiphase parathyroid 4D-CT has evolved from an adjunct imaging technique to a first-line choice for planning parathyroidectomy at some institutions. Here, we review the background, technique, and interpretation of parathyroid 4D-CT. Compared with the traditional modalities of scintigraphy and ultrasound, CT provides superior sensitivity for localizing parathyroid lesions, and is particularly valuable in the setting of planning remedial surgery and when patients have multi-gland disease (double adenomas or four-gland hyperplasia). A three-phase CT protocol optimizes lesion detection and characterization. A systematic approach to image interpretation and reporting, incorporating the Duke 4D-CT scoring system, enables radiologists to convey relevant information and facilitate successful surgery. We recommend using a three-phase CT protocol and provide an updated six-step approach to parathyroid CT interpretation and reporting.

Ruling Out Brain CT Contraindications prior to Intravenous Thrombolysis: Diagnostic Equivalence between a Primary Interpretation Workstation and a Mobile Tablet Computer.

Objective The aim of this study was to evaluate the equivalence of brain CT interpretations performed using a diagnostic workstation and a mobile tablet computer, in a telestroke service. Materials and Methods The ethics committee of our institution approved this retrospective study. A factorial design with 1452 interpretations was used. The assessed variables were the type of stroke classification, the presence of contraindications to the tPA administration, the presence of a hyperdense intracranial artery sign (HMCA), and the Alberta Stroke Program Early CT Score (ASPECTS) score. These variables were evaluated to determine the effect that the reading system had on their magnitudes. Results The achieved distribution of observed lesions using both the reading systems was not statistically different. The differences between the two reading systems to claim equivalence were 1.6% for hemorrhagic lesions, 4.5% for cases without lesion, and 5.2 for overall ischemic lesion. Equivalence was achieved at 2.1% for ASPECTS ≤ 6, 6.5% for the presence of imaging contraindication to the tPA administration, and 7.2% for the presence of HMCA. Conclusion The diagnostic performance for detecting acute stroke is likely equivalent whether a tablet computer or a diagnostic workstation is used or not.

Emergency department interpretation of CT of the brain: a systematic review

Background and objectivesCT of the brain (CTB) is one of the most common radiological investigations performed in the emergency department (ED). Emergency clinicians rely upon this imaging modality to aid...

Commentary on: The accuracy of interpretation of emergency abdominal CT in adult patients who present with non-traumatic abdominal pain: results of a UK national audit

Commentary on: The accuracy of interpretation of emergency abdominal CT in adult patients who present with non-traumatic abdominal pain: results of a UK national audit

The diagnostic challenge of the sequelae of acute pancreatitis on CT imaging: a pictorial essay.

The purpose of the study was to present a pictorial review of the long-term sequelae of acute pancreatitis on CT imaging as these findings can cause diagnostic confusion in the absence of a proper clinical history and/or prior CT imaging. We retrospectively identified 81 patients who had an episode of acute pancreatitis with diagnostic findings on CT and also underwent one or more follow-up CT scans at least 1month beyond the acute episode. The residual findings on all follow-up CT scans were tabulated, including the time interval since the initial bout of acute pancreatitis. Residual inflammatory changes were present in 19.8% of cases, with a median time period lasting 86days since the initial episode of acute pancreatitis. Residual fluid collections were seen in 27.2% and persisted for a median of 132days. Three patients had residual solid-appearing inflammatory masses, which could be mistaken for neoplasms. Other long-term sequelae were also tabulated, including pancreatic ductal dilatation, pancreatic atrophy, new or increased pancreatic calcifications, biliary tract dilatation, central portal venous occlusion, and pseudoaneurysm formation. These residual findings and long-term complications are presented as a pictorial essay. Recognizing the spectrum of residual findings of acute pancreatitis, some of which can be long term, is important in the correct interpretation of a pancreatic CT. These findings can mimic acute pancreatitis or a pancreatic/peripancreatic neoplasm and often cause diagnostic confusion, especially in the absence of prior CT imaging.

Overuse of Head CT Examinations for the Investigation of Minor Head Trauma: Analysis of Contributing Factors

The aim of this study was to estimate the amount of CT studies performed in the emergency department of a tertiary hospital that are not indicated by Canadian CT Head Rule (CCHR) guidelines and to analyze factors that contribute to unnecessary examinations. A total of 955 brain CT examinations performed for minor head injuries were randomly retrospectively selected. Medical records were assessed for the following parameters: demographics, cause of head trauma, and referring physician's seniority and specialty. For each CT scan, it was determined whether the CT referral met the CCHR criteria. The CT interpretations of patients under 65 years of age were evaluated to assess the sensitivity and negative predictive value of the CCHR criteria. A total of 104 examinations (10.9%) were not indicated according to the CCHR, but in patients younger than 65 years, 104 of 279 examinations (37.3%) were not indicated. Neurologists conducted more unwarranted CT studies (odds ratio [OR], 3.5; P= .011), whereas surgeons tended to order fewer studies (OR, 0.676; P= .126). There was no statistically significant difference between the seniority of the referring physician and over-referral (P= .181). Four-wheel motor vehicle accidents (OR, 2.789; P= .001) and a hit on the head by an object (OR, 2.843; P= .006) were associated with a higher rate of nonindicated CT examinations. The CCHR had sensitivity and negative predictive value of 100% for either brain hemorrhage or fractures. Overuse of CT examinations for minor head injuries was demonstrated, especially in young patients, with an excess of 37.3%. Contributing factors are referring physician specialty and injury mechanism. Analysis of overuse causes can be implemented for education programs and for computerized referring protocols.

Granuloma Mimicking Local Recurrence on PET/CT after Liver Resection of Colorectal Liver Metastasis: A Case Report

Positron emission tomography–computed tomography (PET/CT) improves the diagnostic interpretation of fluorine-18 fluorodeoxyglucose (18F-FDG ) PET and CT in oncologic patients and has an impact on both diagnostic and therapeutic aspects of patient management. However, false positive findings from the PET/CT imaging should be taken into consideration as they mislead physicians into improper therapeutic actions. We present a 48-year-old female patient with a history of left colectomy for colorectal cancer and subsequent liver metastasectomy. After one year of follow-up, she presented with a highly suspicious lesion in the liver, which was confirmed on PET/CT as a metastatic liver tumor. Consequently, the patient underwent surgical excision of the tumor, and the definitive histological diagnosis showed a granulomatous tissue with giant cells and foreign body tissue reaction. Based on this report, we briefly review the dangerous pitfalls from radiological and PET/CT imaging concerning the preoperative diagnostic workup examination, as they may significantly alter the treatment plan in oncologic patients.

Interpretation of postmortem head computed tomography for non-traumatic in-hospital deaths by non-radiologists: a preliminary study.

PurposePostmortem computed tomography (PMCT) has recently become important to clarify the cause of death in forensic medicine. It has also been proven to be useful for in-hospital deaths to a certain extent when interpreted by radiologists. However, accuracy of the interpretations of PMCT by non-radiologists remains to be elucidated. Nevertheless, they are often required to write death certificates based on the findings of PMCT in the absence of radiologists in Japan. We compared the interpretations of postmortem head CT (PMCT-H) by non-radiologists with the autopsy findings.MethodsThis study included 13 patients who underwent both brain dissection at autopsy and PMCT between June 2011 and December 2014. All cases were non-traumatic in-hospital deaths. Interpretation of PMCT was performed by the clinicians in charge of the patients, not by radiology experts.ResultsThe patients were first examined with PMCT and then autopsies were performed. Ten out of 13 cases were confirmed to have no lesions in the cranial cavity by both PMCT-H and autopsy. Two cases were diagnosed with intracranial hemorrhage (intracerebral and/or subarachnoid hemorrhage) and one with recurrent malignant lymphoma by both the clinicians and the pathologists. Intracranial hemorrhages were thought to be the direct causes of mortality of the two patients, and recurrent malignant lymphoma was considered to be one of the cardinal findings of the cancer death. There were no discrepancies between PMCT-H and autopsy findings.ConclusionsThe interpretations of PMCT-H by non-radiologists were completely the same as the autopsy findings regarding the non-traumatic in-hospital deaths in this study. It is premature to draw a definitive conclusion at present, but PMCT-H might be as effective as autopsy not only for those lesions described above but also for no remarkable changes in the brain. There has been no report on such a comparison. We believe further verification of the validity of interpretation of PMCT by non-radiologists is worthwhile in terms of death certificates made out in the absence of radiology experts and pathologists.

An Audit on the Role of PET/CT in Recurrent Ovarian Cancer in a Tertiary Care Centre

Ovarian cancers tend to recur in 50–70 % cases. Metastases from ovarian cancer primarily involve the peritoneum rather than parenchymal sites; thus, the presence of small-volume recurrence or metastatic deposits on the visceral surfaces poses a challenge for interpretation of CT and MR images. PET/CT utilizes its property of higher accumulation in malignant cells to provide both anatomic and functional information for diagnosing malignant tumors. The objectives of the study were to find the correlation between PET/CT findings and final histopathological diagnosis in suspected ovarian cancer recurrences. PET/CT was done in cases with rising or above normal CA-125. These patients with abnormal PET/CT findings were taken up for a secondary cytoreductive surgery, and histopathological reports were taken as the standard against which PET/CT positive findings were compared. Of the 52 patients with suspected recurrence, 40 patients with a PET-CT scan with findings suggestive of an avid uptake underwent surgery. Of the 40 patients who underwent a secondary cytoreductive surgery, 38 had histopathologically confirmed recurrence. PET-CT detected a total of 86 lesions, of which 38 were in the lymph nodes, 32 were peritoneal lesions and 14 were pelvic, 2 were metastatic in the parenchyma of liver. Mean diameter of the lesions detected was 2.2 cm (range 0.3–6.2 cm). PET-CT accurately identified 72 of the 80 histopathologically proven lesions. The overall lesion-based sensitivity of PET-CT is 90 %, specificity 66.7 %, positive predictive value being 83.7 % and negative predictive value 77.7 % and the overall accuracy being 81.9 %. Correlation between PET/CT and histopathological disease: κ (Cohen value) = 0.88 suggests excellent correlation. Selected patients with ovarian cancer recurrence may benefit from PET-CT at the time of even no. or minimal CA-125 elevation by early detection and successful cytoreduction.

Therapy Response Assessment and Patient Outcomes in Head and Neck Squamous Cell Carcinoma: FDG PET Hopkins Criteria Versus Residual Neck Node Size and Morphologic Features.

This study investigates the prognostic value of (18)F-FDG PET/CT qualitative therapy assessment (Hopkins criteria) in patients with head and neck squamous cell carcinomas (HNSCCs) with residual neck nodes after definitive chemoradiation therapy and compares the Hopkins criteria with anatomic nodal size and morphologic features for prediction of survival outcomes. A total of 72 patients with HNSCC, with negative primary tumor and positive residual neck nodes (CT criteria > 1 cm short-axis diameter) after the completion of definitive chemoradiation therapy, were included. PET/CT was performed 6-24 weeks after completion of treatment. FDG uptake in residual nodes on PET/CT was interpreted using a structured qualitative 5-point scale (Hopkins criteria). The 5-point scale was dichotomized to negative (scores 1, 2, and 3) or positive (scores 4 and 5) results. Cystic or necrotic nodes were defined as those with central low attenuation with a relatively hyperdense capsule. Kaplan-Meier curve and Cox regression analysis were performed. On the basis of the Hopkins criteria, 10 (13.9%) patients had positive findings and 62 (86.1%) had negative findings for residual nodal disease. According to CT interpretation, 25 patients (34.7%) had residual cervical lymph nodes greater than or equal to 1.5 cm in diameter, and 41 (56.9%) patients had cystic or necrotic nodes. Patients were followed for a median of 27 months after posttherapy PET/CT. There was a statistically significant difference in overall survival (OS) (hazard ratio, 7.06; p < 0.001) and progression-free survival (PFS) (hazard ratio, 6.18; p < 0.001) between patients with negative versus positive residual FDG nodal uptake. There was no statistically significant difference in OS and PFS in patients categorized on the basis of nodal size or morphologic features. PET-based structured qualitative therapy assessment (Hopkins criteria) can predict survival outcomes of patients with HNSCC with residual neck nodes after definitive chemoradiotherapy.

Maximum-Intensity-Projection and Computer-Aided-Detection Algorithms as Stand-Alone Reader Devices in Lung Cancer Screening Using Different Dose Levels and Reconstruction Kernels.

The objective of our study was to evaluate lung nodule detection rates on standard and microdose chest CT with two different computer-aided detection systems (SyngoCT-CAD, VA 20, Siemens Healthcare [CAD1]; Lung CAD, IntelliSpace Portal DX Server, Philips Healthcare [CAD2]) as well as maximum-intensity-projection (MIP) images. We also assessed the impact of different reconstruction kernels. Standard and microdose CT using three reconstruction kernels (i30, i50, i70) was performed with an anthropomorphic chest phantom. We placed 133 ground-glass and 133 solid nodules (diameters of 5 mm, 8 mm, 10 mm, and 12 mm) in 55 phantoms. Four blinded readers evaluated the MIP images; one recorded the results of CAD1 and CAD2. Sensitivities for CAD and MIP nodule detection on standard dose and microdose CT were calculated for each reconstruction kernel. Dose for microdose CT was significantly less than that for standard-dose CT (0.1323 mSv vs 1.65 mSv; p < 0.0001). CAD1 delivered superior results compared with CAD2 for standard-dose and microdose CT (p < 0.0001). At microdose level, the best stand-alone sensitivity (97.6%) was comparable with CAD1 sensitivity (96.0%; p = 0.36; both with i30 reconstruction kernel). Pooled sensitivities for all nodules, doses, and reconstruction kernels on CAD1 ranged from 88.9% to 97.3% versus 49.6% to 73.9% for CAD2. The best sensitivity was achieved with standard-dose CT, i50 kernel, and CAD1 (97.3%) versus 96% with microdose CT, i30 or i50 kernel, and CAD1. MIP images and CAD1 had similar performance at both dose levels (p = 0.1313 and p = 0.48). Submillisievert CT is feasible for detecting solid and ground-glass nodules that require soft-tissue kernels for MIP and CAD systems to achieve acceptable sensitivities. MIP reconstructions remain a valuable adjunct to the interpretation of chest CT for increasing sensitivity and have the advantage of significantly lower false-positive rates.

Magnetic resonance imaging in the evaluation of idiopathic pulmonary fibrosis: a real possibility, or an attractive challenge?

Magnetic resonance imaging in the evaluation of idiopathic pulmonary fibrosis: a real possibility, or an attractive challenge?

Radiology resident MR and CT image analysis skill assessment using an interactive volumetric simulation tool – the RadioLOG project

Assess the use of a volumetric simulation tool for the evaluation of radiology resident MR and CT interpretation skills. Forty-three participants were evaluated with a software allowing the visualisation of multiple volumetric image series. There were 7 medical students, 28 residents and 8 senior radiologists among the participants. Residents were divided into two sub-groups (novice and advanced). The test was composed of 15 exercises on general radiology and lasted 45min. Participants answered a questionnaire on their experience with the test using a 5-point Likert scale. This study was approved by the dean of the medical school and did not require ethics committee approval. The reliability of the test was good with a Cronbach alpha value of 0.9. Test scores were significantly different in all sub-groups studies (p < 0.0225). The relation between test scores and the year of residency was logarithmic (R2 = 0.974). Participants agreed that the test reflected their radiological practice (3.9 ± 0.9 on a 5-point scale) and was better than the conventional evaluation methods (4.6 ± 0.5 on a 5-point scale). This software provides a high quality evaluation tool for the assessment of the interpretation skills in radiology residents. • This tool allows volumetric image analysis of MR and CT studies. • A high reliability test could be created with this tool. • Test scores were strongly associated with the examinee expertise level. • Examinees positively evaluated the authenticity and usability of this tool.

A prospective study evaluating diffusion weighted magnetic resonance imaging (DW-MRI) in the detection of peritoneal carcinomatosis in suspected gynecologic malignancies

To evaluate and compare the ability of DW-MRI and CT to detect sites of peritoneal dissemination in gynecologic malignancies. The reproducibility of DW-MRI and CT interpretation between radiologists was also assessed. Single institution prospective cohort study of women with suspected advanced gynecologic cancer who underwent surgical staging from 2010 to 2013. Participants underwent both DW-MRI and contrast-enhanced CT prior to surgery. Radiologists and surgeons were blinded, respectively, to surgical and DW-MRI results. The area under the receiver operator characteristic curve (AUC) was calculated for each disease site for CT and DW-MRI and compared to surgical findings. Kappa statistics quantified interobserver agreement between both radiologists. Twenty seven patients were enrolled. Mean age at surgery was 59years. Ninety percent of participants had stage IIIC/IV disease. For right diaphragm disease, the AUC for DW-MRI was 0.95 compared to 0.81 for CT. For left diaphragm disease, the AUC was 0.89 for DW-MRI compared to 0.74 for CT. The AUC was similar for DW-MRI and CT for omental disease (0.79 versus 0.64); the liver surface (0.61 versus 0.67); bowel mesentery (0.73 versus 0.64); and cul de sac (0.75 versus 0.64). Interobserver agreement for DW-MRI was greater than CT for omental, Morrison's pouch, liver surface, and right diaphragm disease. DW-MRI detects right diaphragmatic disease found at surgery with greater accuracy than CT. For other disease sites key to surgical planning, DW-MRI is equivalent to CT. Interobserver agreement was superior for a majority of disease sites evaluated by DW-MRI compared to CT.

Diagnostic errors in abdominopelvic CT interpretation: characterization based on report addenda.

The purpose of the article is to characterize the diagnostic errors in abdominopelvic CT interpretation through review of radiology report addenda. We searched abdominopelvic CT reports for the word "addendum" over a nearly seven-year period. Addenda were reviewed to identify those reporting a diagnostic error. Cases were characterized by a spectrum of features. 709 addenda describing 785 diagnostic errors were identified, representing approximately 0.5% of searched reports. 84.1% were a new finding, 5.1% an upgrade in severity of an originally reported finding, 3.9% a downgrade in severity, and 6.9% other modification. The most common anatomic sites, as well as the mostcommon missed abnormality per site, were vasculature (9.8%, atherosclerosis/thrombus), abdominal wall (8.3%, ventral hernia), bone [7.4%, osseous lesion (not clearly benign)], kidney [6.9%, renal lesion (not clearly benign)], liver (6.1%, steatosis), and ureter (5.1%, calculus). Of 209 addenda providing a reason for the change, 30.6% related to comparison with prior imaging, 22.5% additional surgical history, 13.4% referrer request for re-review, 8.6% additional signs, symptoms, or lab abnormality, 8.6% additional known diagnosis, 5.7% attention to patient gender, 5.3% multi-planar reconstructions, and 5.3% consultation with other radiologist. Missed findings rather than misinterpretations of detected abnormalities were the most common reason for abdominopelvic CT report addenda. Awareness of the most common misses by anatomic location may help guide quality assurance initiatives. A wide variety of contributing factors were identified. Informatics and workflow optimization may be warranted to facilitate radiologists' access to all available patient-related data, as well as communication with other physicians, and thereby help reduce diagnostic errors.

Progress in Fully Automated Abdominal CT Interpretation.

Automated analysis of abdominal CT has advanced markedly over just the last few years. Fully automated assessment of organs, lymph nodes, adipose tissue, muscle, bowel, spine, and tumors are some examples where tremendous progress has been made. Computer-aided detection of lesions has also improved dramatically. This article reviews the progress and provides insights into what is in store in the near future for automated analysis for abdominal CT, ultimately leading to fully automated interpretation.

Comparison of near-infrared spectroscopy and head CT interpretations of the ED patients with minor head injury

Abstract This study compares near-infrared spectroscopy device and brain computed tomography results in detection of intracranial hemorrhages of patients in an emergency department with minor head trauma and whose computed tomography scans were obtained. In our prospective and cross-sectional study, sociodemographic and clinical features, and brain computed tomography and near-infrared spectroscopy device data of patients diagnosed with minor head trauma were compared. Among 546 trauma patients diagnosed with minor head trauma, 151 of them met the criteria for inclusion in the study. When compared with brain computed tomography, near-infrared spectroscopy device data are 85.7% sensitive, are 66.6% specific, and have a negative predictive value of 98.9% and a positive predictive value of 11.1%. There was a statistically significant difference in rates of diagnosis of pathology between near-infrared spectroscopy device data and official radiologist decision of brain computed tomography results In our study, although we could not reach evidence showing that Infrascanner could be used as an alternative to cerebral computed tomography in intracranial hemorrhages, it is a valuable screening tool in some cases such as bedside monitoring, mass casualty events, remote areas, ambulance services, and others.