Number Of CT Scans Research Articles

Comparative Analysis of CT Fluoroscopy Modes and Gastropexy Techniques in CT-Guided Percutaneous Radiologic Gastrostomy

Background/Objectives: This study was conducted to compare two modes of computed tomography fluoroscopy (CTF) and two gastropexy techniques used in CT-guided percutaneous radiologic gastrostomy (CT-PRG) aiming to identify the optimal techniques for image guidance and gastropexy and, thus, to overcome the current lack of consensus on the preferred modalities. Methods: We retrospectively identified 186 successful CT-PRG procedures conducted evenly across two university hospitals from January 2019 to December 2023. Patients were divided into two groups (intermittent multislice CT biopsy mode-guided technique (MS-CT BM) and retention anchor suture (T-fastener) versus real-time (RT-)CTF and gastropexy device) for descriptive analysis of demographics, indication for PRG, radiation exposure (DLP), procedural time, number of CT scans, gastropexy time, and complications. Differences were assessed for statistical significance using Fisher’s exact test and the Mann–Whitney U-test. Results: Our final study population comprised 100 patients (50 from each center; 62.52 ± 12.36 years, 73 men). There was a significant difference in radiation exposure between MS-CT BM (group 1) and RT-CTF (group 2), with an average dose-length product (DLP) of 56.28 mGycm×m ± 67.89 and 30.91 ± 27.53 mGycm×cm, respectively (p < 0.001). PRG with RT-CTF guidance was significantly faster than PRG with MS-CT BM, with an average difference of 10.28 min (p < 0.001). No significant difference in duration was found between the two gastropexy methods compared (retention anchor suture, 11.50 ± 5.239 s vs. gastropexy device, 11.17 ± 6.015 s; p = 0.463). Complication rates did not differ significantly either (p = 0.458). Conclusions: Our findings indicate comparable efficacy and safety of the two gastropexy methods and underscore that the choice of CTF mode for image guidance has only a small role in reducing radiation exposure in patients undergoing CT-PRG. Instead, it is essential to avoid control scans.

3D-printed brachytherapy in patients with cervical cancer: improving efficacy and safety outcomes

ObjectiveThis study aims to evaluate the efficacy and safety of 3D printing technology in brachytherapy for cervical cancer, comparing its outcomes with conventional free hand implantation brachytherapy.MethodsA total of 50 cervical cancer patients treated at the First Affiliated Hospital of Gannan Medical College from January 2019 to July 2023 were included in this study. Patients were divided into two groups: 25 patients received intensity-modulated radiotherapy (IMRT) combined with 3D-printed brachytherapy, and 25 patients underwent IMRT combined with free hand brachytherapy implantation. Key indicators analyzed included short-term therapeutic effects, survival outcomes, operation times, the number of CT scans, the number of needles inserted, dosimetric parameters, and complications.ResultsThe use of 3D-printed brachytherapy significantly improved the safety of radiation therapy operations, especially for large tumors (≥ 30 mm), by providing more precise dose distribution and reducing the radiation doses received by critical organs such as the bladder and rectum. Compared to the artificial implant group (88% prevalence), the 3D-printed brachytherapy group showed a significantly lower incidence of radiation enteritis (29.2% prevalence, p < 0.001). There were no significant differences in other complications between the two groups. For instance, the incidence of radiation cystitis was relatively high in the 3D-printed brachytherapy group (79.2% prevalence) compared to the artificial implant group (64% prevalence, p = 0.240). The median follow-up period in this study was 22.5 months [IQR 18–29]. Among the 49 patients included, 43 had cervical squamous carcinoma and 6 had cervical adenocarcinoma. Short-term therapeutic response rates were comparable, with no significant difference in overall survival observed between the two groups.Conclusion3D-printed brachytherapy offers a more effective and safer therapeutic option for patients with cervical cancer, particularly for those with large tumors or complex anatomical structures.

Puncture Cube Patient-Mounted Navigation System versus Freehand Method for CT-Guided Needle Placement: Study on a Neoprene Covered Elliptical Cylinder Gelatin Phantom.

The study aims to show how the "Puncture Cube" (PC) (Medical Templates, Egg, Switzerland) compares to the freehand method (FHM) for CT-guided punctures. The PC is a patient-mounted disassemblable cube consisting of an upper and lower template with multiple holes each to predefine puncture trajectory. A total of 80 punctures (FHM in-plane, FHM off-plane, PC in-plane, PC off-plane) was performed by 4 radiologists on a target 9.1cm below surface level of a neoprene covered elliptical cylinder gelatin phantom. The PC was never disassembled. Evaluated parameters were procedure time, number of CT-scans, euclidean distance (ED) and normal distance (ND). Respective parameters of FHM and PC were compared using the Wilcoxon signed-rank test and Levene test with significance levels of 5%. PC achieved smaller ED and ND values after initial needle insertion without corrections for both in-plane and off-plane punctures (P > 0.05). Variance of initial NDs was off-plane significantly larger for FHM. Final ED after needle path corrections was smaller for FHM both in- and off-plane (P < 0.05). Final off-plane ND was significantly lower for FHM with no significant difference in final in-plane ND. FHM off-plane punctures were significantly faster. There was no significant difference in CT-scans between both methods. Utilizing the PC may improve initial needle positioning and safety especially off-plane. However, better final needle positioning after correction with the greater freedom of movement method may suggest need for disassembly of the cube.

Did medical doctors who order abdominal CT scans during on-call hours truly become worse at clinical reasoning? Yes, they did

ObjectiveTo investigate temporal changes in clinical reasoning quality of physicians who requested abdominal CT scans at a tertiary care center during on-call hours within a 15-year period.MethodsThis retrospective study included 531 patients who underwent abdominal CT at a tertiary care center during on-call hours on 36 randomly sampled unique calendar days in each of the years between 2005 and 2019. Clinical reasoning quality was expressed as a percentage (0–100%), taking into account the degree by which the differential diagnoses on the CT request form matched the CT diagnosis. Temporal changes in the quality of clinical reasoning and number of CT scans were assessed using Mann-Kendall tests. Associations between the quality of clinical reasoning with patient age and gender, requesting department, and time of CT scanning were determined with linear regression analyses.ResultsThe median annual clinical reasoning score was 14.7% (interquartile range: 12.2 to 16.0%; range: 7.7 to 34.6%). The quality of clinical reasoning significantly decreased between 2005 and 2019 (Mann-Kendall Tau of −0.390, p = 0.048), while the number of abdominal CT scans significantly increased (Mann-Kendall tau of 0.790, p < 0.001).ConclusionThe clinical reasoning quality of physicians who request abdominal CT scans during on-call hours has deteriorated over time. Clinical reasoning appears to be worse in younger patients.Key Points• In patients with suspected acute abdominal pathology who are scheduled to undergo CT scanning, referring physicians generally have difficulties in making an accurate pretest (differential) diagnosis.• Clinical reasoning quality of physicians who request acute abdominal CT scans has deteriorated over the years, while the number of CT scans has shown a significant increase.• Clinical reasoning quality appears to be worse in younger patients in this setting.

Examining potential confounding factors in gene expression analysis of human saliva and identifying potential housekeeping genes

Isolation of RNA from whole saliva, a non-invasive and easily accessible biofluid that is an attractive alternative to blood for high-throughput biodosimetry of radiological/nuclear victims might be of clinical significance for prediction and diagnosis of disease. In a previous analysis of 12 human samples we identified two challenges to measuring gene expression from total RNA: (1) the fraction of human RNA in whole saliva was low and (2) the bacterial contamination was overwhelming. To overcome these challenges, we performed selective cDNA synthesis for human RNA species only by employing poly(A)+-tail primers followed by qRT-PCR. In the current study, this approach was independently validated on 91 samples from 61 healthy donors. Additionally, we used the ratio of human to bacterial RNA to adjust the input RNA to include equal amounts of human RNA across all samples before cDNA synthesis, which then ensured comparable analysis using the same base human input material. Furthermore, we examined relative levels of ten known housekeeping genes, and assessed inter- and intra-individual differences in 61 salivary RNA isolates, while considering effects of demographical factors (e.g. sex, age), epidemiological factors comprising social habits (e.g. alcohol, cigarette consumption), oral hygiene (e.g. flossing, mouthwash), previous radiological diagnostic procedures (e.g. number of CT-scans) and saliva collection time (circadian periodic). Total human RNA amounts appeared significantly associated with age only (P ≤ 0.02). None of the chosen housekeeping genes showed significant circadian periodicity and either did not associate or were weakly associated with the 24 confounders examined, with one exception, 60% of genes were altered by mouthwash. ATP6, ACTB and B2M represented genes with the highest mean baseline expression (Ct-values ≤ 30) and were detected in all samples. Combining these housekeeping genes for normalization purposes did not decrease inter-individual variance, but increased the robustness. In summary, our work addresses critical confounders and provides important information for the successful examination of gene expression in human whole saliva.

A study on the learning curve for a new radioactive seed template retainer assisted by CT-guided radioactive seed implantation for advanced non-small cell lung cancer

ObjectiveTo explore the application of a new radioactive seed template retainer in the learning curve of CT-guided 125I seed brachytherapy (CTISBT) for advanced non-small cell lung cancer (NSCLC). MethodsThis study retrospectively analyzed the medical records of 60 patients who underwent CTISBT for advanced NSCLC by a single physician between January 2018 and December 2019. The data were sorted in order of admission and divided into three groups according to the order of surgery, group A (cases 1–20), group B (cases 21–40), and group C (cases 41–60). All patients underwent preoperative planning and postoperative dosimetry verification, and the operation time, intraoperative CT scans, postoperative hospital stay, and postoperative complications were compared among the three groups. The quality of life (QOL) score and tumor volume were compared before and 2 months after surgery. ResultsThere were no statistically significant differences among the three groups in QOL scores, tumor volume, and tumor site before CTISBT assisted by the new radioactive seed template retainer. However, the surgical time differed significantly between the three groups (P ​< ​0.01). The operation time was longer in group A than that in groups B and C (P ​< ​0.01). There was no significant difference between groups B and C. There were no significant differences in the number of CT scans among the three groups and the length of postoperative hospital stay. The follow-up QOL and tumor volume were significantly reduced at 2 months after surgery compared with those before surgery (P ​< ​0.01). ConclusionsThe short-term efficacy of the new radioactive seed template retainer-assisted CTISBT was definitive for advanced NSCLC. After the physician had accumulated experience with 20 cases of a new type of radioactive seed template retainer-assisted CTISBT surgery, the follow-up operation time was significantly shortened and the learning curve entered the plateau stage.

Effect of COVID-19 on the Number of CT-scans and MRI Services of Public Hospitals in Iran: An Interrupted Time Series Analysis.

In February 2020, the Ministry of Health and Medical Education in Iran announced the first case of COVID-19. The aim of this study was to investigate the impact of COVID-19 on the number of CT-Scans and MRI services in public hospitals in western Iran. We collected CT-scans and MRI services data from 18 public hospitals via Vice-Chancellor Office, Lorestan University of Medical Sciences from January 2017 to February 2021. Interrupted time series analysis (ITSA) was conducted to assess the impact of COVID-19 on CT-Scans and MRI services. More specifically, ITSA was conducted using ordinary least squares regression with the number of CT-Scans and MRI services per 1,000 registered persons per month as dependent variable. At the beginning of the observation period, the monthly rate of CT-Scans was constant (p for trend = 0.267) at 291.9 (from 95%CI 240.5 to 343.4) per 1,000 registered patients. The first case of COVID-19 coincided with an abrupt increase by 211.8 (from 95%CI 102.9 to 320.7) per 1,000 patients. Thereafter, the trend of CT-Scans did not change (p=0.576) compared to the pre-pandemic period. The rate of MRI services was 363.5 per 1,000 per registered patients per month (P = <0.0001) with a slightly decreasing trend (coefficient=-5; 95%CI, -6.9 to -3.1). The findings of this study showed that crises such as COVID-19 can affect the service delivery process. Health policymakers and decision makers should work to prevent potential reductions in health care during events such as COVID-19.

Assessment of radiation doses and image quality of multiple low-dose CT exams in COVID-19 clinical management

PurposeThe Corona Virus Disease 2019 (COVID-19) was first reported in December 2019 from an outbreak of unexplained pneumonia in Wuhan (Hubei, China) that subsequently spread rapidly around the world. Because of the public health emergency, chest CT has been widely used for sensitive detection and diagnosis, monitoring the changes of lesions and also for treatment evaluation. The purpose of this study was to investigate radiation dose and image quality of chest CT scans received by COVID-19 patients and to evaluate the oncogenic risk of multiple chest CT examinations.MethodsA retrospective review of 33 patients with RT-PCR confirmed COVID-19 infection was performed from January 31, 2020 to February 19, 2020. The date of each CT exam and respective radiation dose for each exam was recorded for all patients. Multiple pulmonary CT scans were obtained during diagnosis and treatment procedure. Scan frequency, total scan times, radiation dose, and image quality were determined.ResultsThirty-three patients (15 males and 18 females, age 21–82 years) with confirmed COVID-19 pneumonia underwent a total of 143 chest CT scans. The number of CT scans per patient was 4 ± 1, with a range of 2–6. The time interval between two consecutive chest CT scans was 3 ± 1 days. The average effective dose from a single chest CT scan was 1.21 ± 0.10 mSv, with a range of 1.02–1.44 mSv. The average cumulative effective dose per patient was 5.25 ± 1.52 mSv, with a range of 2.24–7.48 mSv. The maximum cumulative effective dose was 7.48 mSv for six CT examinations during COVID-19 treatment. Based on subjective image quality analysis, the visual scoring of CT findings was 11.23 ± 1.35 points out of 15 points.ConclusionsThe frequency, total number and image quality of chest CT scans should be reviewed carefully to guarantee minimally required CT scans during the COVID-19 management.

Clinical value of an electromagnetic navigation system for CT-guided percutaneous lung biopsy of peripheral lung lesions.

BackgroundThe purpose of this study was to retrospectively evaluate the clinical value of an electromagnetic navigation system for CT-guided percutaneous lung biopsy of peripheral lung lesions.MethodsThis was a retrospective study. Patients with peripheral lung lesions in our institution between January 2019 and December 2020, who underwent lung biopsy assisted by the electromagnetic navigation system were included in Group A, and those who underwent lung biopsy using conventional CT-guided percutaneous lung biopsy were included in Group B. The general features and clinical and technical information of each patient were collected and evaluated in both groups.ResultsA total of 141 patients were included in Group A (78 males and 63 females; median age, 65 years; range, 32–79 years), and 96 patients were included in group B (57 males and 39 females; median age, 65 years; range, 34–80 years). The technical success rate was 100% in both groups. The technical efficacy rate was 92.9% and 90.6% in Groups A and B (P=0.525), respectively. There was no significant difference in surgical time and the number of CT scans between the two groups, and only grade 1–2 complications occurred in the patients.ConclusionsThe electromagnetic navigation system is an effective and safe auxiliary tool for CT-guided percutaneous lung biopsy of peripheral lung lesions.

Development of a 3D-Printed Navigational Template for Establishing Rabbit VX2 Lung Cancer Model

The CT-guided percutaneous puncture-inoculation for establishing the rabbit VX2 lung cancer model (LCM) is time-consuming, requires repeated CT scans, and has a high complication rate. Therefore, this study aimed to develop a navigational template using 3D technology to provide an alternative method for establishing the model with improved success and complication rates. Ideal pressure was determined using chest CT data from 15 anesthetized rabbits fitted with sphygmomanometer cuff around their chests. Subsequently, a preliminary 3D template with a square window and cross-sign to facilitate precise installation was designed. Using another 20 rabbits fixed with the preliminary template, an ideal common puncture point and parameter were determined, a navigational tunnel was set up on the template surface, and the final puncture navigational template was printed out. Eight-four rabbits (42/group) were assigned to the experimental (template-guided puncture) and control (traditional puncutre) groups and underwent VX2 tumor-fragment inoculation to validate the template. Differences in various parameters between two groups were analyzed. The ideal pressure was 30 mmHg. All rabbits were inoculated successfully and the template adequately fit the rabbit chest. The experimental group displayed significantly better operation time (198.93±36.64 vs 735.14±91.19 seconds); number of CT scans (0 vs 7.19±1.64); pneumothorax (11.9% vs 35.7%), chest seeding (16.7% vs 35.7%), and mid-lung field tumor-bearing (88.1% vs 59.5%) rates than the control group (all, P <0.05). The groups did not differ in rib injury, tumor volume or survival time (all, P > 0.05). We successfully developed a puncture navigational template, providing an alternative method for establishing the rabbit VX2 LCM.

Calcium Identification and Scoring Based on Echocardiography. An Exploratory Study on Aortic Valve Stenosis.

Currently, an echocardiography expert is needed to identify calcium in the aortic valve, and a cardiac CT-Scan image is needed for calcium quantification. When performing a CT-scan, the patient is subject to radiation, and therefore the number of CT-scans that can be performed should be limited, restricting the patient’s monitoring. Computer Vision (CV) has opened new opportunities for improved efficiency when extracting knowledge from an image. Applying CV techniques on echocardiography imaging may reduce the medical workload for identifying the calcium and quantifying it, helping doctors to maintain a better tracking of their patients. In our approach, a simple technique to identify and extract the calcium pixel count from echocardiography imaging, was developed by using CV. Based on anonymized real patient echocardiographic images, this approach enables semi-automatic calcium identification. As the brightness of echocardiography images (with the highest intensity corresponding to calcium) vary depending on the acquisition settings, echocardiographic adaptive image binarization has been performed. Given that blood maintains the same intensity on echocardiographic images—being always the darker region—blood areas in the image were used to create an adaptive threshold for binarization. After binarization, the region of interest (ROI) with calcium, was interactively selected by an echocardiography expert and extracted, allowing us to compute a calcium pixel count, corresponding to the spatial amount of calcium. The results obtained from these experiments are encouraging. With this technique, from echocardiographic images collected for the same patient with different acquisition settings and different brightness, obtaining a calcium pixel count, where pixel values show an absolute pixel value margin of error of 3 (on a scale from 0 to 255), achieving a Pearson Correlation of 0.92 indicating a strong correlation with the human expert assessment of calcium area for the same images.

Using CT scout view to scan illicit drug carriers may reduce radiation exposure

ObjectiveThe aim of this study was to present our experience on the evaluation of suspected illicit drug carriers via computerized tomography scout view (CTSV) with analysis of detectability and features such as content, form and density. MethodsA total of 120 individuals suspected of body packing were screened via CT in a university emergency department between January 2014 and December 2017. Results88.3% of 120 body packing cases examined in the study were male. The median (1st quartile–3rd quartile) age of the cases was 35.5 (30–41) years. We found that solid packs have a 4.573-fold higher likelihood of detection in CTSV screening than liquid ones (95%CI: 1.879–11.134). Additionally, the number of CT scans needed were significantly associated with capsule localization (stomach) (OR:7.178, 95%CI: 2.420–21.293) and solid form packs (OR: 8.705, 95%CI: 2.318–32.692) are associated with number of CT scans. ConclusionCTSVs have a successful detection rate, especially in solid form packs. Our results suggest that conclusive CTSV imaging for body packing may be recommended to delay the application of the next CT scan until the passage of the first capsule; thereby preventing unnecessary radiation exposure.

Conversion factors to derive organ doses for canine subjects undergoing CT examinations.

Although a large number of CT scans are being conducted on small animals, especially in Western countries, little is known of absorbed dose from veterinary CT scans. In the current retrospective analytical study, we estimated the radiation dose delivered to dogs from CT scans with various scan protocols and compared the results with those of human patients. We adopted a total of three computerized canine models with three sizes combined with a computer simulation model of a CT scanner. The eyes of the dog model received the greatest dose, 1.10 mGy/mGy, in the head scan, followed by a brain dose of 0.85 mGy/mGy. In the chest, abdomen-pelvis (AP), chest-abdomen-pelvis, and head-chest-abdomen-pelvis scans, the heart wall (0.93 mGy/mGy), ovaries (0.99 mGy/mGy), lungs (1.12 mGy/mGy), and thyroid (1.23 mGy/mGy) received the greatest organ doses, respectively. The smallest dog model received up to 1.4-fold greater organ doses than the largest dog in both the chest and AP scans. Overall, the medium-size canine model received organ doses comparable to those of the 1-year-old child model in the head scan, the 5-year-old child in chest scan, and the 10-year-old child in AP scan. The organ dose conversion factors derived from this study should help evaluate absorbed dose for canine patients undergoing CT exams.

Impact of an Augmented Reality Navigation System (SIRIO) on Bone Percutaneous Procedures: A Comparative Analysis with Standard CT-Guided Technique.

(1) Background: The purpose of this study is to evaluate the impact of an augmented reality navigation system (SIRIO) for percutaneous biopsies and ablative treatments on bone lesions, compared to a standard CT-guided technique. (2) Methods: Bioptic and ablative procedures on bone lesions were retrospectively analyzed. All procedures were divided into SIRIO and Non-SIRIO groups and in <2 cm and >2 cm groups. Number of CT-scans, procedural time and patient’s radiation dose were reported for each group. Diagnostic accuracy was obtained for bioptic procedures. (3) Results: One-hundred-ninety-three procedures were evaluated: 142 biopsies and 51 ablations. Seventy-four biopsy procedures were performed using SIRIO and 68 under standard CT-guidance; 27 ablative procedures were performed using SIRIO and 24 under standard CT-guidance. A statistically significant reduction in the number of CT-scans, procedural time and radiation dose was observed for percutaneous procedures performed using SIRIO, in both <2 cm and >2 cm groups. The greatest difference in all variables examined was found for procedures performed on lesions <2 cm. Higher diagnostic accuracy was found for all SIRIO-assisted biopsies. No major or minor complications occurred in any procedures. (4) Conclusions: The use of SIRIO significantly reduces the number of CT-scans, procedural time and patient’s radiation dose in CT-guided percutaneous bone procedures, particularly for lesions <2 cm. An improvement in diagnostic accuracy was also achieved in SIRIO-assisted biopsies.

Utilization Review of Imaging Equipment: An insight into CT Scanning

Introduction: Radio diagnosis service plays a crucial role in diagnosis of the patient’s disease. The volumeof patients utilising this service is very high. This service also takes away the sizeable share of total capitalinvestment and therefore, the optimal utilization of this service becomes important.Methodology: Literature review was done through Google scholar, electronic database of PubMed andother relevant databases. The query terms like Utilization Review of Imaging Equipment, Utilisation of CTScanners, Capacity of Scanners in Radiology and Waiting Times for Imaging were used to fetch the relevantdata sources. Around 130 articles were reviewed and analysed.Results: The number of CT Scans per 1 million of population in High Income (HI), Upper Middle Income(UMI), Lower Middle Income (LMI) are 14.7, 7.3, 3.7. The CT scanners are one of the most expensivepieces of medical equipment in hospitals, with CT scanners costing between $1 million (?7 crore) and $2million (?14 crore).There is a substantial variation in the utilisation of these services, including number of scans per day andwait times. Increasing the scanner efficiency and utilisationcan significantly decrease the cost per scan andincrease access to imaging services.Expanding capacity, improving operating procedures by reducing change-over times, and improvingcapacity allocation in combination with scheduling procedures can contribute to the overall reduction of CTaccess time.Discussion and Conclusion: By acquiring Utilization data about CT Scanners, we get to know a completeand accurate overview of how Scanners are used. The CT scanner utilisation can be improved in both publicand private health sector by analysingthe key information about the utilisation of their own and other healthservices’ CT scanners.

Abstract P432: Large Scale, CTEvaluation Can Improve Screening for Multi-Center Stroke Trials

Introduction: Artificial intelligence (AI) can automate the detection and triage of ICH. ENRICH is a RCT evaluating the efficacy of MIS for ICH. AI ENRICH is a prospective trial operating within and in parallel to the ENRICH trial that utilizes an AI application, Viz RECRUIT and ICH VOLUME to identify and segment ICH to quickly identify potentially eligible subjects. Methods: Non-contrast CT scans performed at 5 participating US hospitals were evaluated specifically for a parenchymal hemorrhage by Viz ICH VOLUME. Participating health care professionals downloaded a phone application that allowed one to be notified for any hemorrhage ≥ 5 mL. Time metrics included the onset of CT scan, phone alert, and user recognition of that alert. Results: Over a combined period of 220 days, 8714 CT scans were evaluated by the Viz ICH VOLUME application. Of these, 257 CT scans were determined to contain an ICH yielding a total of 45 patients that met ENRICH criteria for trial inclusion (30-80 mL). The median time from CT scan to cell phone notification was 2:52 minutes (IQR=0.002) . The median time from cell phone notification to the user viewing the CT scan was 3:00 minutes (IQR=55.5 minutes), which was altered by a few significant delays in recognizing the alert (e.g. coordination of alerts and call schedules). After segregating the 4 weeks after ENRICH restarted on 7/14/20 into 2 week blocks, recognition of an alert within 5 minutes increased from 9% to 61.5% at the first site and 36% to 61.5% at second site - demonstrating the ability of alerts to improve site engagement and active screening for new subjects. Conclusions: In conclusion, Viz ICH VOLUME can screen large numbers of CT scans and send alerts within minutes to medical professionals. Studies relying on radiographic selection criteria may benefit from automated screening, although participating health care providers need to make use of the technology in order to maximize benefit.

Towards a benchmark of abdominal CT use during duty shifts: 15-year sample from the Netherlands

PurposeTo investigate temporal changes in the utilization and patient impact of abdominal CT during duty shifts in the past 15 years.MethodsThis study included a random sample of 1761 abdominal CT scans that were made during evening and night duty shifts in a tertiary care center between 2005 and 2019.ResultsThe number of CT scans significantly increased (almost threefold) between 2005 and 2019 (Mann–Kendall tau of 0.829, P < 0.001). The proportion of negative CT scans (i.e., the absence of findings related to the reason that the CT scan was made and no disease deterioration or other new and clinically relevant findings compared to a previous imaging examination when available) was 40.0% (700/1749) in the entire 15-year study frame and did not significantly change over time (Mann–Kendall tau of − 0.219, P = 0.276). The overall frequency of same-day hospital discharge after negative CT was 20.6% (150/729) in the past 15 years and showed a significant increase over time (Mann–Kendall tau of 0.505, P = 0.010). The overall proportion of CT scans with incidental findings was 3.4% (60/1761) and remained statistically stable over the past 15 years (Mann–Kendall tau of − 0.057, P = 0.804).ConclusionOver the past 15 years, the number of CT scans and the frequency of same-day hospital discharge after negative CT have increased, while the proportions of negative CT scans and incidental findings have remained stable in our tertiary care center. The data from this study can be used for interinstitutional benchmarking to define, monitor, and improve the appropriateness of imaging utilization.

Effect of physical activity level on the course of pneumonia caused by COVID-19

Data from medical records of 144 COVID-19 patients who completed inpatient treatment, as well as subsequent questionnaires using a modified questionnaire, were analyzed. The relationship between the level of physical activity, performance, and quality of life (before and after treatment), age, frequency of exercise therapy at the hospital stage, the presence of stool disorders, and episodes of increased blood pressure after treatment with the course of the disease were evaluated. Patients were divided into a control and experimental group depending on the initial subjective level of performance. The moderate form prevailed (69,44%). The mild form is typical for younger patients, patients older than 50 years make up 62,49% of the total number of cases of severe course. Patients who had a severe form of the disease noted the quality of life and performance before the disease at a lower level, in contrast to those who had a medium and light form. Initially leading a more active lifestyle, patients with initially higher performance and quality of life who performed exercise therapy at the hospital stage (with mild and moderate forms) have a more favorable course of the disease (reducing the time of hospitalization, early recovery of performance, reducing the number of CT scans). The initial higher physical activity contributes to a more favorable course of the disease. The initial higher physical activity contributes to a more favorable course of the disease. It is necessary to raise public awareness of the benefits of regular physical activity and its connection with the course of the disease, especially among the elderly, as well as to introduce exercise therapy at all stages of treatment.

Utilization of imaging and outcomes of care among metastatic colorectal cancer (mCRC) patients (pts) receiving bevacizumab containing regimens.

e14011 Background: Chemotherapy combined with bevacizumab is the most commonly used treatment first line therapy in pts with mCRC. Decisions for continuation or change of chemotherapy are based on the findings of CT scan, the most commonly used from of imaging in this population. Modeled after clinical trials, CT scan every 2 months is adopted as a standard of care. Yet, patterns of utilization of CT scan in general population is unknown. We set to explore CT scan utilization and associated outcomes among pts with mCRC. Methods: The De-identified Clinformatics Data Mart (OptumInsight, Eden Prairie, MN) covering January 2008 to December 2016 was used for this analysis. Pts with two out-patient and/or one in-patient ICD codes for colorectal cancer were identified. Pts with at least 180 days of enrollment, no chemotherapy within 120 days prior to chemotherapy, and at least one claim for CT scan were eligible for analysis. Recipients of FOLFOX (CAPOX) or FOLFIRI (XILIRI) +bevacizumab were identified using HCPCS codes and the data of their 1sttreatment was registered as index date. The primary endpoint of the analysis was exposure to both FOLFIRI and FOLFOX, secondary endpoint was survival. SAS software was used for data processing and analysis. Results: A total of 3261 pts met the inclusion criteria 78% with oxaliplatin based regimens and 22% with irinotecan regimens. The median age of the population is 66 (19-89), and 58.3% of the identified pts were male. The median duration of first line therapy was 119 days. Median number of CT scan during first line was 2.3. The median and mean number of CT scan per 2 months were 0.82 and 0.94. There was no difference in age, gender, and comorbidities in those with less than 2 vs. 2 or more CT scans. Exposure to both regimens (measured with switching from one regimen to another) was 35% in pts with less than 2 CT scans and 44% in those with 2 or more CT scan (p-value &lt; 0.0001). Probability of survival at 12 months was 83% for all patients regardless of the frequency of scans. Conclusions: In patients with mCRC more frequent scans is associated with higher probability of access to active agents. However, survival probability at 12 months was not different between the two groups.

Utilization of imaging in pancreatic adenocarcinoma patients status post Whipple procedure.

e16725 Background: Pancreatic adenocarcinoma (PAC) remains the third leading cause of cancer death in the Western world. The 5-year survival of patients with PAC remains at 4%. Proper utilization of imaging to detect recurrence is necessary in patients who have undergone a Whipple procedure. Currently, Carbohydrate (CA) 19-9 is used for screening and is the only biomarker approved by the Food and Drug Administration (FDA). Sensitivity and specificity range from 79-81% and 82-90%. We intend to evaluate our single institute experience of imaging utilization, CA 19-9, and surgical specimen histopathologic features in the surveillance of PAC patients status post Whipple. Methods: Retrospective analysis of patients with a diagnosis of PAC who underwent imaging status post Whipple from 2008 - 2018 was completed. Cross-sectional imaging and clinical data was obtained from the electronic health record. Results: A total of 197 PAC patients status post Whipple were identified with mean age at diagnosis at 64.4 years and male to female ratio of 1.3. 85 patients were found to have died during treatment. The median survival for these patients was 68 years. Of the patients who died status post Whipple, postoperative CA 19-9 levels within 6 months of the procedure were elevated (p = 0.01). Patients who were found to have stage II to IV PAC at diagnosis were found to have a high CA 19-9 level within 6 months post-Whipple when compared to stage I patients (p &lt; 0.05). Patients who were found to have less than 5 surveillance CTs status post Whipple were found to have higher CA 19-9 levels within 6 months status post Whipple (p &lt; 0.01). There was no difference in number of CT scans between stages. Of those patients who died with stage I or II PAC at diagnosis, a large number were found to have less than 5 surveillance CT studies completed status post Whipple (p &lt; 0.05). Furthermore, a higher cancer stage at diagnosis correlated with worse pathologic differentiation of the cancer (p &lt; 0.001). Conclusions: Post Whipple CA 19-9 correlated with stage, recurrence, number of scans, and survival.