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European Radiology
Erschienen in: European Radiology 2/2011

01.02.2011 | Chest

The clinical impact of high resolution computed tomography in patients with respiratory disease

verfasst von: Nicholas J. Screaton, Fiona N. A. C. Miller, Bipen D. Patel, Ashley Groves, Angela D. Tasker, David A. Lomas, Christopher D. R. Flower

Erschienen in: European Radiology | Ausgabe 2/2011

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Abstract

Objective

High resolution computed tomography is widely used to investigate patients with suspected diffuse lung disease. Numerous studies have assessed the diagnostic performance of this investigation, but the diagnostic and therapeutic impacts have received little attention.

Methods

The diagnostic and therapeutic impacts of high resolution computed tomography in routine clinical practice were evaluated prospectively. All 507 referrals for high-resolution computed tomography over 12 months in two centres were included. Requesting clinicians completed questionnaires before and after the investigation detailing clinical indications, working diagnoses, confidence level in each diagnosis, planned investigations and treatments.

Results

Three hundred and fifty-four studies on 347 patients had complete data and were available for analysis. Following high-resolution computed tomography, a new leading diagnosis (the diagnosis with the highest confidence level) emerged in 204 (58%) studies; in 166 (47%) studies the new leading diagnosis was not in the original differential diagnosis. Mean confidence in the leading diagnosis increased from 6.7 to 8.5 out of 10 (p < 0.001). The invasiveness of planned investigations increased in 23 (7%) studies and decreased in 124 (35%) studies. The treatment plan was modified after 319 (90%) studies.

Conclusions

Thoracic high-resolution computed tomography alters leading diagnosis, increases diagnostic confidence, and frequently changes investigation and management plans.
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Metadaten
Titel
The clinical impact of high resolution computed tomography in patients with respiratory disease
verfasst von
Nicholas J. Screaton
Fiona N. A. C. Miller
Bipen D. Patel
Ashley Groves
Angela D. Tasker
David A. Lomas
Christopher D. R. Flower
Publikationsdatum
01.02.2011
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 2/2011
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-010-1923-3

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