Role of MDCT in Oncological Emergencies in a Tertiary Care Oncological Centre
Journal Title: International Journal of Anatomy Radiology and Surgery - Year 2019, Vol 8, Issue 2
Abstract
ABSTRACT Introduction: With increasing incidence of cancer in the general population along with improved treatment and better survival, many patients may need urgent care during the course of the disease and treatment. In this retrospective study at a tertiary level cancer institute, we have evaluated the role of Multi Detector Computed Tomography (MDCT) in the diagnostic work-up of patients presenting with acute conditions that would need immediate surgical or medical attention. This is probably the first study on onco-emergencies where varied acute clinical conditions involving multiple organ systems have been evaluated by MDCT. Aim: To evaluate the role of MDCT in diagnosing the patients presenting with acute conditions in an oncological setup. Materials and Methods: Retrospective search of the radiology department database of one year at the tertiary oncology center revealed 100 CT scans of patients who were referred to CT presenting with clinically suspected acute conditions. In addition the CT scans of those patients in which acute emergencies were detected by the MDCT, without clinical suspicion were also included. The CT diagnosis was then compared with the final clinical diagnosis made (before discharge or before death of the patient), which was a combination of clinical, imaging, biochemical and histopathological findings. This final clinical diagnosis was considered as the gold standard. In few cases where CT did not reveal any diagnosis, follow up clinical data and conclusive clinical diagnosis were studied, noted and compared with the CT diagnosis. Sensitivity, specificity, positive predictive value and negative predictive value were calculated. Results: Among the 100 patients, 31 patients had cardiac and vascular emergencies, 30 had gastrointestinal emergencies, 18 patients had cerebral emergencies, 11 patients had thoracic/pulmonary emergencies, seven had genitourinary emergencies and three patients had musculoskeletal/soft tissue emergencies. MDCT detected lesions in 92 patients with sensitivity of 96.7% and specificity of 71.4%. Positive predictive value of CT was 97.8 % while negative predictive value was 62.5%. Conclusion: MDCT plays an important role in the initial diagnosis of acute conditions in a known cancer patient. Hence, CT can be considered as first line of investigation in many acute conditions in these cancer patients to avoid delay in diagnosis. In an oncology set-up, MDCT can provide otherwise unobtainable information which helps in definitive diagnosis and guides the physicians for appropriate treatment which may be lifesaving and at least improve short term outcomes in these groups of cancer patients.
Authors and Affiliations
Anuradha Rao, Pallavi Kamat, P Raghuram
Keywords
Related Articles
- EP ID EP609779
- DOI 10.7860/IJARS/2019/39911:2471
- Views 135
- Downloads 0
Giant Plexiform Neurofibromatosis of the Thoracolumbar Region: A Case Report
Neurofibromas are tumours arising from connective tissue of the nerve. Cutaneous manifestations are generally seen in Neurofibromatosis Type 1 (NF1). Whereas, Neurofibromatosis Type 2 (NF2) has CNS manifestations. Plexif...
An Unusual Finding of Double Fused YShaped Loop of Ansa Cervicalis and its Clinical Significance
ABSTRACT The ansa cervicalis (AC) is a neural loop formed by union of superior root derived from ventral ramus of C1 through hypoglossal nerve and inferior root derived from ventral rami of C2 and C3. The aim of this cas...
CT Evaluation of Small Bowel Wall Lesions
Introduction: MDCT has lead to vast improvement in depiction and characterisation of small bowel wall lesions especially differentiation of benign and malignant lesions. Aim: To evaluate the role of MDCT in suspected sma...
Bilateral Perisylvian Syndrome with Typical Imaging Features– A Case Report
ABSTRACT Bilateral perisylvian syndrome is a congenital neurological disorder characterised by abnormal distribution of neurons in cortex. Unilateral entity may also occur but is less common. Bilateral perisylvian syndro...
Situs InversusTotalis with Malposition of Caecum and Ascending colon
ABSTRACT Situs Inversus Totalis (SIT) is an inversion anomaly involving the position of abdominal and thoracic viscera with respect to the midline. The medical and surgical management of these patients are technically mo...