A new analysis has unearthed high rates of incidental findings on pediatric CT scans for trauma.
Such unexpected results—occurring in the periphery of an imaging exam performed for different reasons—were present in about 27% of cases among patients under 21, researchers detailed in Clinical Imaging. Roughly 10% necessitated immediate or urgent action, while more than half were benign and required no further follow-up.
The findings were derived from a comprehensive literature review, conducted by scientists with the USC Keck School of Medicine and the Mayo Clinic and published Saturday.
“The authors hope to shed light on the prevalence of such findings, which could have important implications for clinical management and resource allocation in pediatric trauma care,” Amir Hassankhani, MD, a radiology research scholar at Mayo’s Rochester, Minnesota, location, and colleagues wrote Sept. 9. “By analyzing the available data, this review aimed to provide a comprehensive and evidence-based assessment of the issue, which could inform future research and clinical practice in this field.”
Researchers conducted their search via multiple medical literature databases on March 6, targeting studies that described incidental findings on CT scans in trauma patients under. They separated cases into three categories: (1) requiring immediate or urgent response, (2) likely benign but may require outpatient follow-up and (3) benign anatomic variants or pathologic findings that require no additional care.
The search turned up seven studies for inclusion. Aggregated across all of them, incidental finding frequencies were 10.15% for the more critical category 1, 32.18% for category 2 and 51.44% for category 3. Hassankhani et al. speculated on several reasons for such rates of misses among pediatric patients. Unique anatomical variations and tissue structures in children’s developing bodies may make it more difficult to spot such concerns, they noted. Interpreting CTs among this population “can be challenging,” given the smaller size of internal structures, along with possible motion artifacts. Plus, advances in CT make it easier to spot subtle abnormalities that went undetected in the past.
“These factors should be considered when interpreting CT scans in pediatric patients,” the authors advised. “Moreover, certain clinical conditions, such as trauma, may require a more extensive CT scan, which could increase the likelihood of incidental findings.”
Hassankhani and colleagues also cautioned that there was notable variation among the seven studies, which could have potentially skewed the results. Further research is needed to better understand this phenomenon.
“The substantial heterogeneity among the studies included in this analysis suggested that caution should be taken when interpreting these results,” the authors concluded. “A subgroup meta-analysis conducted on pediatric abdominal CT scans revealed a higher pooled incidence of incidental findings [47.17%]. However, due to the limited number of studies included, the generalizability of these findings to other types of CT scans or settings may be limited.”
Read more in the official journal of the New York Roentgen Society at the link below.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.