RSNA News - February 2005

A press release has been sent to the medical news media for the following scientific article appearing in the February 2005 issue of Radiology (rsna.org/radiologyjnl):

"Cost-Effectiveness of Whole-Body CT Screening"

One-time whole-body CT (WBCT) screening provides minimal gains in life expectancy (six days) while adding an additional cost of $2,513 per individual, when compared to routine care.

Molly T. Beinfeld, M.P.H., from Massachusetts General Hospital in Boston, and colleagues performed their analysis using a hypothetical cohort of 500,000 50-year-old asymptomatic, self-referred men.

They found that in this population, one-time screening with WBCT would cost an additional $151,000 per life-year saved and that WBCT is more expensive—on a cost per life-year basis—than the majority of healthcare interventions currently funded in the United States.

"Serious considerations of the costs and benefits of this technology should ensue before it is more widely used," they write.

Schematic of the decision-analytic model with life expectancy (LE) and cost outcomes used in the cost-effectiveness analysis.

Indirect CT Venography with CT Pulmonary Angiography: Increase in Thromboembolic Disease Detection

Adding indirect CT venography (CTV) to CT pulmonary angiography (CTPA) can increase the detection rate of thromboembolic disease by 20 percent.

Matthew D. Cham, M.D., and colleagues from New York-Weill Medical Center studied 1,590 consecutive patients undergoing CTPA for the suspicion of pulmonary embolism (PE). Two minutes after completion of CTPA, they performed contiguous indirect CTV from the iliac crest to the popliteal fossa.

The researchers detected PE in 243 patients (15 percent) by CTPA, while deep vein thrombus (DVT) was detected in 148 patients (nine percent) patients by indirect CTV. Among the patients who had DVT, 100 had PE on CTPA.

They write: "In this study, we found that combined CTPA-indirect CTV increases thromboembolic disease detection by 20 percent compared to CTPA alone. This result is similar to our previous findings, where the detection rate of thromboembolic disease was increased by 18 percent using indirect CTV in 541 patients. Our current results lend further support to the consistent diagnostic yield that can be expected from indirect CTV examination."

Indirect CT venogram of the left common femoral vein shows a deep venous thrombus (arrow).

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