Dados do Trabalho

Título

QCT in chronic lung diseases: A Real-life Study of Changes in Physician ́s Decision Making

Introdução

Introduction and objective: The quantitative computed tomography (QCT) technique combined with techniques based on density and texture, allows accurate diagnosis and longitudinal management, improving the characterization and quantification of the disease, increasing the reproducibility of the evaluation of its severity. This study aims to determine how the diagnoses, diagnostic certainty and management decisions of physicians are affected by the QCT results of chronic lung diseases.

Casuística e Métodos

Material and methods:​​ We identified patients who attended the thoracic diseases outpatient clinic of five centers, who were referred for CT with chronic lung disease. In order to identify associations between the characteristics of the physician and the patient and the study measures, a multiple regression analysis was used. For statistical analyses, software was used, and the proportion of cases in which the QCT helped to confirm or exclude a diagnosis was calculated, and to change any aspect of management. The independent variables of the study were: place of care, years of experimental physician's professional, training status, sex and age of the physician and sex of the patient. The dependent variables were: new diagnosis and change in the level of diagnostic confidence. The acquisition of CT images was performed in a 64-cut scanner, with a thickness of 1 mm, 120 kVp and 200 mAs.

Resultados

Results and discussion:​ The lead diagnosis was ILD and emphysema. In the pre-CT diagnosis, confidence was inversely associated with the probability of a diagnostic change. The median changes in confidence increased by 52.7% and 45.1%, respectively, for COPD and ILD patients; in the post-CT obtained 75% for both. After tomography, the diagnosis of confidence improved substantially and significantly between indications, reaching evenly high levels.

Conclusões

Conclusion: Physicians' diagnoses and diagnostic confidence changed after the QCT, and diagnostic uncertainty was eased.

Palavras Chave

Key-words: Quantitative computed tomography; Diagnostic; Chronic lung diseases.

Área

Alunos de Medicina / Ligas radiológicas (trabalhos de extensão acadêmica)