OUTCOME OF EXAMINATIONS SELF-REFERRED AS A RESULT OF SPIRAL CT OF THEABDOMEN

Rationale and Objectives. The interpretation of an abdominal computed tomographic (CT) scan is occasionally inconclusive. In many of these c ases, the radiologist suggests an additional imaging test for further confirmation or clarification. The purpose of this study was to evalua te the outcome of self-referral by the radiologist after abdominal CT scanning. Materials and Methods. Reports from 545 consecutive abdomina l CT scans were reviewed to track recommendations for additional imagi ng. In patients who underwent the additional work-up, a determination of the effect of the study was attempted. In patients who did not, exp lanations were sought. Wording of the recommendations was also recorde d. Results. Recommendations were made for additional imaging studies i n 105 (19.3%) patients. Of these, 32 (30.5%) were performed and 31 (96 .9%) were helpful by confirming malignancy (n = 5), confirming a benig n process (n = 24) or being therapeutic (n = 2). In one, no informatio n was added. There were 63 (60.0%) patients who did not undergo the re commended studies. Reasons included ''no clinical indication'' (n = 51 ), alternative study performed (n = 9), or study previously performed (n = 3). In eight (7.6%) patients the chart provided insufficient info rmation about whether the patient underwent the study, and in two (1.9 %) the chart was unavailable. Wording of the recommendation had no eff ect on whether the study was performed (P > .05). Conclusion. Although interpretation of abdominal CT scans leads to recommendations for add itional imaging in a minority of cases, these recommendations were inf requently followed. When followed, however, the findings from the reco mmended studies were usually helpful. Better clinical information is p erhaps the best way to reduce self-referral by radiologists.