title: Role of computed tomography at a cancer center emergency department.
abstract: To evaluate the imaging methods used at the emergency department (ED) of a cancer center, with emphasis on computed tomography (CT). A descriptive, retrospective, single-center study was conducted by reviewing imaging exams and medical records, after approval of the institution's Ethics Review Board. The demographic data, cancer history, and imaging exam requested were evaluated for all patients and the indications and results of head, chest, and abdominopelvic CT scans were also evaluated. During the study period, there were 8710 visits to the ED, and 5999 imaging studies were requested in 3788 patients (43.5 % of total of visits). One thousand eight hundred twenty-nine CT exams were used in 1121 visits (12.9 % of total of visits). The mean age of patients was 57.7 years and most patients (93.2 %) had a known primary tumor. The most common indications for abdominopelvic CT were non-oncologic emergencies (26.7 %) and postoperative complications (19.2 %), and the results were negative in 36.6 %, positive for clinical suspicion in 49.0 %, and incidental positive in 14.5 %. The most frequent indication for chest CT was suspected pulmonary embolism (34.4 %); however, only 11.1 % confirmed the diagnosis. The results of head TC were negative in 72.9 % and the indications that had more positive findings were suspected metastasis (32.1 %) and focal neurological sign/altered level of consciousness (24.5 %). CT plays an important role in driving the cancer patients visiting the ED. However, the high rate of negative or discordant results causes a concern for the inadvertent and excessive use of this imaging modality.
authors.affiliation: Department of Imaging, AC Camargo Cancer Center, R. Prof. Antonio Prudente, 211, São Paulo, SP, 09015-010, Brazil.
authors.forename: Jessyca Couto
authors.initials: JC
authors.lastname: Otoni
authors.affiliation: Department of Imaging, AC Camargo Cancer Center, R. Prof. Antonio Prudente, 211, São Paulo, SP, 09015-010, Brazil.
authors.forename: Julia
authors.initials: J
authors.lastname: Noschang
authors.affiliation: Department of Imaging, AC Camargo Cancer Center, R. Prof. Antonio Prudente, 211, São Paulo, SP, 09015-010, Brazil.
authors.forename: Thábata Yaedu
authors.initials: TY
authors.lastname: Okamoto
authors.affiliation: Department of Imaging, AC Camargo Cancer Center, R. Prof. Antonio Prudente, 211, São Paulo, SP, 09015-010, Brazil.
authors.forename: Diego Rosseman
authors.initials: DR
authors.lastname: Vieira
authors.affiliation: Department of Imaging, AC Camargo Cancer Center, R. Prof. Antonio Prudente, 211, São Paulo, SP, 09015-010, Brazil.
authors.forename: Michel Souto Mayor
authors.initials: MS
authors.lastname: Petry
authors.affiliation: Department of Imaging, AC Camargo Cancer Center, R. Prof. Antonio Prudente, 211, São Paulo, SP, 09015-010, Brazil.
authors.forename: Lucas
authors.initials: L
authors.lastname: de Araujo Ramos
authors.affiliation: Department of Imaging, AC Camargo Cancer Center, R. Prof. Antonio Prudente, 211, São Paulo, SP, 09015-010, Brazil.
authors.forename: Paula Nicole Vieira Pinto
authors.initials: PN
authors.lastname: Barbosa
authors.affiliation: Department of Imaging, AC Camargo Cancer Center, R. Prof. Antonio Prudente, 211, São Paulo, SP, 09015-010, Brazil. almir.bitencourt@accamargo.org.br.
authors.forename: Almir Galvão Vieira
authors.initials: AG
authors.lastname: Bitencourt
authors.affiliation: Department of Imaging, AC Camargo Cancer Center, R. Prof. Antonio Prudente, 211, São Paulo, SP, 09015-010, Brazil.
authors.forename: Rubens
authors.initials: R
authors.lastname: Chojniak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: Cancer; Computed tomography; Diagnostic imaging; Emergency department