title: Diagnostic value of CT-localizer and axial low-dose computed tomography for the detection of drug body packing.
abstract: OBJECTIVE
  The purpose of this study was to assess the diagnostic performance of CT-localizers in the detection of intracorporal containers.
  
  
  METHODS
  This study was approved by the research ethics committee of our clinic. From March 2012 to March 2013, 108 subjects were referred to our institute with suspected body packing. The CT-localizer and the axial CT-images were compared by two blinded observers retrospectively. Presence of body packs was assessed in consensus. Sensitivity and specificity, PPV and NPV of the CT-localizer were calculated.
  
  
  RESULTS
  Packets were detected in the CT-localizer of 19 suspects. In 28 of 108 cases packs were detected in axial CT-images. Sensitivity of CT-localizer for detection of packs was 0.68, and specificity was 1.00. There were no cases rated as false positive. The PPV was 1.0 and the NPV was 0.89. The omission of the axial CT-images would have led to a mean radiation dose reduction of 1.94 ± 0.5 mSv.
  
  
  CONCLUSIONS
  The value of CT-localizers lies in their high PPV. Localizers are limited by low sensitivity, compared to axial CT-images in screening of potential body packers. However, in positive cases their high PPV may possibly allow to omit the complete axial abdominal CT to achieve even lower radiation exposure.
authors.affiliation: University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf, Germany. Electronic address: Joel.Aissa@med.uni-duesseldorf.de.
authors.forename: Joel
authors.initials: J
authors.lastname: Aissa
authors.affiliation: University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf, Germany.
authors.forename: Antonia
authors.initials: A
authors.lastname: Kohlmeier
authors.affiliation: University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Rubbert
authors.affiliation: Hauptzollamt Düsseldorf, Sachgebiet C/KE 23, Überwachungsgruppe Rauschgift/Waffen, Terminalring 1, D 40474, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hohn
authors.affiliation: Städtische Kliniken Mönchengladbach GmbH, Elisabeth-Krankenhaus Rheydt, Department of Radiology and Nuclear Medicine, D-41239 Mönchengladbach, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Blondin
authors.affiliation: University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Schleich
authors.affiliation: University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf, Germany.
authors.forename: Patric
authors.initials: P
authors.lastname: Kröpil
authors.affiliation: University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Boos
authors.affiliation: University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf, Germany.
authors.forename: Gerald
authors.initials: G
authors.lastname: Antoch
authors.affiliation: University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf, Germany.
authors.forename: Falk
authors.initials: F
authors.lastname: Miese
mesh_terms: D000293:Adolescent; D000328:Adult; D064423:Drug Trafficking; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Body packing; CT; Cocaine; Dose reduction; Localizer