TY - JOUR
T1 - The utilisation and diagnostic yield of radiological imaging in a specialist functional GI disorder clinic
T2 - an 11-year retrospective study
AU - Breen, Micheal
AU - Murphy, Kevin P.
AU - O’Neill, Siobhan B.
AU - O’Donovan, Joanne P.
AU - McWilliams, Sebastian
AU - Desmond, Alan N.
AU - Shanahan, Fergus
AU - Quigley, Eamonn M.
AU - Maher, Michael M.
N1 - Publisher Copyright:
© 2014, European Society of Radiology.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2014/11/14
Y1 - 2014/11/14
N2 - Objectives: The term functional gastrointestinal disorders (FGID) describes various aggregations of chronic gastrointestinal (GI) symptoms not explained by identifiable organic pathology; accordingly, their diagnosis rests on symptom-based criteria and a process of exclusion. Evidence is lacking on the appropriate use of abdominal imaging studies (AIS) in FGIDs.Methods: We investigated the utilisation of AIS (site, modality, diagnostic yield/significance) at a tertiary FGID clinic over an 11-year period.Results: Of 1,621 patients, 507 (31 %; 67.5 % women, mean age 43.9 ± 17.37 years) referred from primary care had 997 AIS (1.7 per patient): ultrasonography (US) 36.1 %, fluoroscopy (FLS) 28.8 %, computed tomography (CT) 19.6 %, plain radiography (PR) 13.5 %, nuclear medicine (NM) 1 %). Of the 997 AIS, 55.6 % (554/997) were normal. Of the AIS with positive findings, 9.9 % (62/625) were deemed ‘probably significant’ and 14.7 % (92/625) ‘significant’. Of the CT and FLS studies, 12.3 % and 13.6 %, respectively, yielded ‘significant’ abnormalities compared to 2.2 % of the US studies and 2.1 % of the PR studies. CT identified five of seven neoplasms, associated with male sex, increasing age and symptom onset after age 50 years.Conclusions: This study confirmed low use of AIS in tertiary FGID clinics and a high proportion of normal studies. Barium swallow/meal and CT were more likely to identify ‘probably significant’ or ‘significant’ findings, including neoplasms.• Abdominal radiographs accounted for 13.5 % of investigations yet were normal in 71.8 %.Key Points: • Imaging referral rates from a specialist functional gastrointestinal disorder clinic are low.• Despite this, normal studies are still frequent in those who are imaged.• Ultrasonography was the most frequent investigation, yet yielded significant findings infrequently.• CT and fluoroscopy were more likely to yield positive findings.
AB - Objectives: The term functional gastrointestinal disorders (FGID) describes various aggregations of chronic gastrointestinal (GI) symptoms not explained by identifiable organic pathology; accordingly, their diagnosis rests on symptom-based criteria and a process of exclusion. Evidence is lacking on the appropriate use of abdominal imaging studies (AIS) in FGIDs.Methods: We investigated the utilisation of AIS (site, modality, diagnostic yield/significance) at a tertiary FGID clinic over an 11-year period.Results: Of 1,621 patients, 507 (31 %; 67.5 % women, mean age 43.9 ± 17.37 years) referred from primary care had 997 AIS (1.7 per patient): ultrasonography (US) 36.1 %, fluoroscopy (FLS) 28.8 %, computed tomography (CT) 19.6 %, plain radiography (PR) 13.5 %, nuclear medicine (NM) 1 %). Of the 997 AIS, 55.6 % (554/997) were normal. Of the AIS with positive findings, 9.9 % (62/625) were deemed ‘probably significant’ and 14.7 % (92/625) ‘significant’. Of the CT and FLS studies, 12.3 % and 13.6 %, respectively, yielded ‘significant’ abnormalities compared to 2.2 % of the US studies and 2.1 % of the PR studies. CT identified five of seven neoplasms, associated with male sex, increasing age and symptom onset after age 50 years.Conclusions: This study confirmed low use of AIS in tertiary FGID clinics and a high proportion of normal studies. Barium swallow/meal and CT were more likely to identify ‘probably significant’ or ‘significant’ findings, including neoplasms.• Abdominal radiographs accounted for 13.5 % of investigations yet were normal in 71.8 %.Key Points: • Imaging referral rates from a specialist functional gastrointestinal disorder clinic are low.• Despite this, normal studies are still frequent in those who are imaged.• Ultrasonography was the most frequent investigation, yet yielded significant findings infrequently.• CT and fluoroscopy were more likely to yield positive findings.
KW - Functional gastrointestinal disorders
KW - Imaging
KW - Irritable bowel syndrome
KW - Radiology
KW - Ultrasonography
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U2 - 10.1007/s00330-014-3315-6
DO - 10.1007/s00330-014-3315-6
M3 - Article
C2 - 25059676
AN - SCOPUS:84911806669
VL - 24
SP - 3097
EP - 3104
JO - European Radiology
JF - European Radiology
SN - 0938-7994
IS - 12
ER -