A systematic review and meta-analysis of incidental findings in computed tomography scans for pediatric trauma patients
Amir Hassankhani, Melika Amoukhteh, Payam Jannatdoust, Parya Valizadeh, Jennifer H Johnston, Ali Gholamrezanezhad
Clin Imaging . 2023 Nov:103:109981. doi: 10.1016/j.clinimag.2023.109981. Epub 2023 Sep 9.
Purpose: To quantitatively synthesize and report the frequency and category of incidental findings on Computed Tomography (CT) scans in pediatric trauma patients.
Methods: A thorough literature search was carried out in PubMed, Scopus, and Web of Science databases until March 6, 2023, in adherence to the preferred reporting items for systematic review and meta-analyses (PRISMA) guidelines. Studies describing incidental findings on CT scans in trauma patients ≤21 years were included. Incidental findings were grouped into three categories: Category 1 (requiring immediate or urgent evaluation or treatment), Category 2 (likely benign but which may require outpatient follow-up), and Category 3 (benign anatomic variants or pathologic findings that do not require follow-up or intervention).
Results: Seven studies were included in this study, which revealed a combined rate of 27.10 % of incidental findings with notable heterogeneity among the studies. Aggregated frequencies were 10.15 % for Category 1, 32.18 % for Category 2 and 51.44 % for Category 3. Subgroup meta-analysis on abdominal CT scans showed a higher pooled incidence of incidental findings at 47.17 %, but with lower heterogeneity than the general meta-analysis.
Conclusion: The study underscores the prevalence of incidental findings in pediatric trauma patients undergoing CT scans. The categorization of these findings provides useful information for clinicians in determining appropriate follow-up and management strategies.