title: The value of precontrast thoraco-abdominopelvic CT in polytrauma patients.
abstract: OBJECTIVE
  To evaluate the utility and radiation dose of thoraco-abdominopelvic precontrast CT in polytrauma patients.
  
  
  METHODS
  We examined retrospectively 125 patients who underwent a thoraco-abdominopelvic CT for trauma. Two radiologists, independently, evaluated precontrast CT acquisition and two other radiologists examined the contrast-enhanced scans. A further two radiologists assessed both the acquisitions. Mean value of sensitivity (SE), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) were calculated by each group of radiologists. For 104 patients, CTDIvol, DLP data and individual mean size were collected to calculate effective dose.
  
  
  RESULTS
  Mean values of SE, SP, PPV and NPV of findings of radiologists who assessed contrast-enhanced acquisitions were respectively: SE=85%, SP=98%, PPV=86%, NPV=88% versus: SE=43%, SP=95%, PPV=69%, NPV=88% of radiologists who examined non-contrast-enhanced scans. Mean values of radiologists who analyzed both acquisitions were: SE=80%, SP=97%, PPV=80%, NPV=88%. Neither the precontrast scans nor the precontrast and postcontrast scans together provided additional useful information compared to the single contrast-enhanced acquisition. Patients received a mean dose of 12 mSv for the precontrast CT.
  
  
  CONCLUSIONS
  Precontrast CT acquisition did not provide significant information in trauma patients, exposing them to an unjustified radiation dose.
authors: Department of Radiology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20121 Milan, Italy. Electronic address: rxandreaesposito@yahoo.it.
authors: A A
authors: AA
authors: Esposito
authors: Department of Radiology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20121 Milan, Italy. Electronic address: massimo.zilocchi@gmail.com.
authors: M
authors: M
authors: Zilocchi
authors: Department of Radiology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20121 Milan, Italy. Electronic address: fasapier65@gmail.com.
authors: P
authors: P
authors: Fasani
authors: School of Radiology, University of Milan, Via A. di Rudinì 8, Milan, Italy. Electronic address: caterina.giannitto@gmail.com.
authors: C
authors: C
authors: Giannitto
authors: School of Radiology, University of Milan, Via A. di Rudinì 8, Milan, Italy. Electronic address: maccagnnisara@libero.it.
authors: S
authors: S
authors: Maccagnoni
authors: School of Radiology, University of Milan, Via A. di Rudinì 8, Milan, Italy. Electronic address: marinamaniglio@gmail.com.
authors: M
authors: M
authors: Maniglio
authors: Medical Phisic Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20121 Milan, Italy. Electronic address: campoleoni@policlinico.mi.it.
authors: M
authors: M
authors: Campoleoni
authors: Medical Phisic Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza, 35, 20121 Milan, Italy. Electronic address: roberto.brambilla@policlinico.mi.it.
authors: R
authors: R
authors: Brambilla
authors: Computer Science Department, University of Milan, Via Comelico 39, Milan, Italy. Electronic address: casiraghi@di.unimi.it.
authors: E
authors: E
authors: Casiraghi
authors: Department of Radiology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20121 Milan, Italy. Electronic address: pibionde@tin.it.
authors: P R
authors: PR
authors: Biondetti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging*; D015588:Observer Variation; D010388:Pelvis / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D011860:Radiography, Abdominal / Q000379:methods*; D013902:Radiography, Thoracic / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: CT protocol; Dose reduction; Emergency radiology; Polytrauma; Whole body CT