Is direct radiologist supervision of abdominal computed tomography (CT) scans necessary?

To determine the effect of direct radiological supervision of patients attending for abdominal CT by assessing the frequency of protocol alteration subsequent to radiologist review of the images obtained.

A prospective questionnaire-based observational study was performed of 187 consecutive patients undergoing abdominal CT. The CT protocol was determined by a radiologist in advance, with reference to the request form. Any subsequent change in the prescribed study that was contingent on radiologist review of the images obtained was documented on the questionnaire. Comparison was made with a second (control) group of 100 patients undergoing cranial CT.

A protocol change was undertaken following radiologist review of the CT images of 17 (9%) of the group undergoing abdominal CT, compared with 14 (14%) of the group undergoing cranial CT. In the abdominal CT group, further scanning was performed for lesion characterization, to guide a subsequent interventional procedure, because of inadequate anatomical coverage or to evaluate an unexpected lung tumour. There was no significant difference in proportions between the two groups (p=0.23).

When abdominal and cranial CT studies were compared, there was no significant difference in the proportion of studies requiring a change in the prescribed protocol following radiologist review of the images obtained. There was no evidence to suggest that abdominal CT was any less suited to protocol.