Ultra-low Dose Computed Tomography for Pneumonia in the Emergency Department: A Feasibility Study

Auteurs-es

  • Danilo Bianco Radiology Department, Hospital Israelita Albert Einstein, São Paulo, Brasil https://orcid.org/0000-0003-4277-9131
  • Tarso Acoorsi Emergency Department, Hospital Israelita Albert Einstein, São Paulo, Brasil https://orcid.org/0000-0002-8023-3466
  • José de Souza Emergency Department, Hospital Israelita Albert Einstein, São Paulo, Brasil https://orcid.org/0000-0001-6017-7682
  • Eduardo Mello Emergency Department, Hospital Israelita Albert Einstein, São Paulo, Brasil https://orcid.org/0000-0002-7667-9182
  • Joselito Silva Emergency Department, Hospital Israelita Albert Einstein, São Paulo, Brasil https://orcid.org/0000-0001-9677-3785
  • Gustavo Telles Radiology Department, Hospital Israelita Albert Einstein, São Paulo, Brasil https://orcid.org/0000-0002-5405-5029
  • Rodrigo Chate Radiology Department, Hospital Israelita Albert Einstein, São Paulo, Brasil
  • Andre Santos Radiology Department, Hospital Israelita Albert Einstein, São Paulo, Brasil
  • Renato Moron Radiology Department, Hospital Israelita Albert Einstein, São Paulo, Brasil
  • Fernando Mattos Emergency Department, Hospital Israelita Albert Einstein, São Paulo, Brasil https://orcid.org/0000-0002-6310-7695
  • Adriana Telles Emergency Department, Hospital Israelita Albert Einstein, São Paulo, Brasil https://orcid.org/0000-0001-5616-4299
  • Roger Oliveira Emergency Department, Hospital Israelita Albert Einstein, São Paulo, Brasil https://orcid.org/0000-0002-3195-5382
  • Elizabeth Almeida Emergency Department, Hospital Israelita Albert Einstein, São Paulo, Brasil https://orcid.org/0000-0003-2401-2324
  • Paulo Zimmer Emergency Department, Hospital Israelita Albert Einstein, São Paulo, Brasil
  • Marcelo Funari Radiology Department, Hospital Israelita Albert Einstein, São Paulo, Brasil https://orcid.org/0000-0002-6369-3612
  • Marcelo Benveniste Department of Thoracic Radiology, University of Texas MDAnderson Cancer Center, Houston, USA https://orcid.org/0000-0003-1191-8020
  • Gilberto Szarf Radiology Department, Hospital Israelita Albert Einstein, São Paulo, Brasil https://orcid.org/0000-0002-1941-7899

DOI :

https://doi.org/10.25748/arp.33024

Résumé

Background: Role of ultra-low-dose chest CT (ULDCT) in the emergency department is unknown.

Purpose: This study sought to examine feasibility of ULDCT in adults presenting to the emergency department for whom pneumonia was suspected. Radiation dose and time interval between medical request and ULDCT results were measured, antibiotic prescriptions was correlated.

Methods: Between October 2017 and December 2018, we prospectively enrolled consecutive healthy adult patients in a single-center for whom community-acquired pneumonia was suspected for whom no definitive diagnosis was possible by clinical judgment. Exclusion criteria comprised all chronic conditions could impact severity and interpretation of image.

Results:   131 eligible patients (mean age 43.5 years; 57% men) were enrolled to ULDCT. Eighteen (13.7%) patients were excluded. Average CT radiation dose was 0.14  mSv. Time interval between medical request and ultra-low-dose chest CT result was 43 minutes. Only 15.9% of patients with negative CT received antibiotics.

Conclusion: Ultra-low-dose chest CT was feasible for almost all patients in a group of healthy adults presenting to the emergency department with suspected community-acquired pneumonia. Results were made available in a reasonable interval, and negative ones were associated with a low antibiotic prescription rate.

Keywords: Pneumonia, Computed Tomography, Antibacterial Agents, Emergency Medical Services.

 

Biographie de l'auteur-e

Danilo Bianco, Radiology Department, Hospital Israelita Albert Einstein, São Paulo, Brasil

Danilo Bianco combina 16 anos de vasta experiência como médico especialista e gestor de negócios no segmento da Saúde. O profissional é especialista em radiologia torácica e cardiovascular pelo Instituto do Coração do Hospital das Clínicas de São Paulo (InCor-HCFMUSP) e pelo Instituto de Radiologia da Faculdade de Medicina de São Paulo (InRad-HCFMUSP). Danilo é graduado em Medicina pela Pontifícia Universidade Católica de São Paulo e tem Pós-Graduação Lato Sensu em MBA Executivo pelo Instituto de Ensino e Pesquisa de São Paulo (INSPER). Também é reconhecido como mestre em Medicina pela Universidade do Porto, em Portugal, com validação de seu diploma de médico.

Bianco, atualmente, atua como Coordenador Médico do Hospital Israelita Albert Einstein, 34° Melhor Hospital do Mundo pela revista Newsweek. Trata-se do responsável pela Unidade Alphaville integrando as equipes de Radiologia Cardiopulmonar, Ultrassonografia Geral e Doppler Vascular, ou seja, Danilo coordena as atividades desenvolvidas na medicina diagnóstica por imagem, acompanhando e orientando as equipes nos diversos procedimentos envolvidos neste setor.

No Albert Einstein, o profissional está envolvido no diagnóstico e acompanhamento de diversas patologias com exames de imagem de sua expertise. Também faz parte do seu trabalho auxiliar no desenvolvimento de ações e processos internos, visando garantir a excelência na qualidade dos serviços prestados na instituição.

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Publié-e

2024-06-07

Numéro

Vol. 36 No. 1 (2024)

Rubrique

Artigos Originais