Are CT angiograms overused?

The number of CT angiograms (CTAs) has gone up substantially, but the number of pulmonary emboli found has not, leading some researchers to question the utilization of this procedure.

Researchers reviewed 1,384 records of patient who underwent a CTA for suspected pulmonary embolism during a seven-month period (March-September) in 2002, 2003 and 2004. "The total number of CTAs performed during the study interval in 2004 was 43% higher than in 2002 and 47% higher than in 2003," said Tom Reed, a medical student at Albert Einstein College of Medicine in Bronx, NY, and lead author of the study.

There were 443 CTAs performed, with 62 positive for pulmonary embolism in 2002; 432 CTAs were done, with 50 positive for disease in 2003, and 634 CTAs were done with 58 positive in 2004, Reed said. "The percentage of patients with pulmonary embolism diagnosed at CTA dropped from 14 percent in 2002 to nine percent in 2004," Reed said.

"This data shows that we need to take a closer look at the utilization of CTA; every attempt should be made to consider using tests that are less expensive and use less radiation dose," Reed said.

Anna Rozenshtein, MD, and John Austin, MD, mentored Reed on the project. The study will be part of an electronic exhibit at the ARRS Annual Meeting in New Orleans, LA.



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