RSNA 2017 CT Preview

Study finds CT is overused for minor head injuries

By Abraham Kim, staff writer

November 2, 2017 --

Monday, November 27 | 3:10 p.m.-3:20 p.m. | SSE19-02 | Room N230B
A majority of CT scans of the head used to evaluate minor injuries may be unnecessary, say Italian researchers.

As the widely recognized gold standard for examining head trauma, head CT is frequently performed on patients with minor head trauma to let physicians know if surgical intervention will be necessary, Dr. Michaela Cellina from ASST Fatebenefratelli Sacco in Milan told Because less than 1% of minor head trauma cases require surgery, performing head CT on all such patients would be unreasonable both economically and in terms of patient safety.

"During our work, my colleagues and I noted that the number of head CT scans for [minor head trauma] was exceptionally high and that many requests seemed inappropriate," Cellina said.

The researchers collected 492 head CT scans of patients 18 to 45 years old who presented to the emergency department with minor head injury between January 1 and June 30, 2016. The bulk of the scans were found to be unnecessary, based on the Canadian CT Head Rule guidelines (52%) and the National Institute for Health and Care Excellence (NICE) guidelines (76%).

"Despite the implementation of clinical decision rules for the use of CT in [minor head trauma], we observed an important overuse of CT examinations for [minor head trauma] in young patients," Cellina said. "An analysis of the causes for overuse should be carried out in every emergency department to target specific intervention, as education of staff members, in order to reduce the number of unwarranted head CT scans."