when us? when ct? fern karlicki, md. when us? when ct? after this talk, participants should: –be...
TRANSCRIPT
When US? When CT?When US? When CT?
Fern Karlicki, MDFern Karlicki, MD
When US? When CT?When US? When CT?
After this talk, participants should:After this talk, participants should:– Be familiar with the strengths and Be familiar with the strengths and
weaknesses of US & CTweaknesses of US & CT
– Be familiar with how to use the ACR Be familiar with how to use the ACR appropriateness criteriaappropriateness criteria
US StrengthsUS Strengths
MultiplanarMultiplanar
Real timeReal time
No ionizing radiationNo ionizing radiation
Minimal bio-effectsMinimal bio-effects
No IV contrastNo IV contrast
InexpensiveInexpensive
PortablePortable
US WeaknessesUS Weaknesses
Operator dependentOperator dependentLimited by:Limited by:– Gas - pancreas, lung, bowelGas - pancreas, lung, bowel– Bone – ribsBone – ribs– ObesityObesity– MetalMetal
Need patient cooperationNeed patient cooperationLess sensitivity and specificityLess sensitivity and specificity
CT StrengthsCT Strengths
Prettier picturesPrettier pictures
Better resolutionBetter resolution
Better sensitivity & specificityBetter sensitivity & specificity
CT WeaknessesCT Weaknesses
Ionizing radiationIonizing radiation
Limited planesLimited planes
Contrast allergy, nephrotoxicityContrast allergy, nephrotoxicity
Ionizing radiationIonizing radiation
ExpenseExpense
IONIZING RADIATIONIONIZING RADIATION
CT & Cancer / LeukemiaCT & Cancer / Leukemia
1:1000 cancer induction in children after 1:1000 cancer induction in children after single abdominal CT scan!single abdominal CT scan!
Adults have same risk after 5-6 abdominal Adults have same risk after 5-6 abdominal CT scansCT scans
Younger women and children have highest Younger women and children have highest risk risk
ACR WebsiteACR Website
For an excellent discussion of For an excellent discussion of appropriateness of different imaging appropriateness of different imaging modalities in various clinical scenariosmodalities in various clinical scenarios
www.acr.org /ac www.acr.org /ac
oror
Google - acr appropriateness criteriaGoogle - acr appropriateness criteria
ACR - AC RLQ painACR - AC RLQ pain
Reprinted with permission of the American College of Radiology No other representation of this material is authorized without expressed, written permission from the American College of Radiology. Refer to the ACR website at www.acr.org/ac for the most current and complete version of the ACR Appropriateness Criteria..
ACR – AC RLQ painACR – AC RLQ pain
Reprinted with permission of the American College of Radiology No other representation of this material is authorized without expressed, written permission from the American College of Radiology. Refer to the ACR website at www.acr.org/ac for the most current and complete version of the ACR Appropriateness Criteria..
ACR – AC RLQ painACR – AC RLQ pain
Reprinted with permission of the American College of Radiology No other representation of this material is authorized without expressed, written permission from the American College of Radiology. Refer to the ACR website at www.acr.org/ac for the most current and complete version of the ACR Appropriateness Criteria..
ACR – AC HematuriaACR – AC Hematuria
Reprinted with permission of the American College of Radiology No other representation of this material is authorized without expressed, written permission from the American College of Radiology. Refer to the ACR website at www.acr.org/ac for the most current and complete version of the ACR Appropriateness Criteria..
ACR – AC HematuriaACR – AC Hematuria
Reprinted with permission of the American College of Radiology No other representation of this material is authorized without expressed, written permission from the American College of Radiology. Refer to the ACR website at www.acr.org/ac for the most current and complete version of the ACR Appropriateness Criteria..
ACR – AC HematuriaACR – AC Hematuria
Reprinted with permission of the American College of Radiology No other representation of this material is authorized without expressed, written permission from the American College of Radiology. Refer to the ACR website at www.acr.org/ac for the most current and complete version of the ACR Appropriateness Criteria..
ACR Appropriateness CriteriaACR Appropriateness CriteriaAcute Onset Flank PainAcute Onset Flank Pain
Reprinted with permission of the American College of Radiology No other representation of this material is authorized without expressed, written permission from the American College of Radiology. Refer to the ACR website at www.acr.org/ac for the most current and complete version of the ACR Appropriateness Criteria..
Last thoughtLast thought
When US and CT have a similar When US and CT have a similar appropriateness level , consider US first appropriateness level , consider US first especially in especially in childrenchildren, , young slim adultsyoung slim adults and in and in women of child-bearing agewomen of child-bearing age in in order to minimize the risks of radiation in order to minimize the risks of radiation in these patients.these patients.