New research published in Clinical Radiology highlights the value of full body CT scans for diagnosing sepsis in patients admitted to the ICU, with experts reporting the modality can detect the “majority” of underlying infection.
Sepsis and septic shock can be deadly if not caught and treated promptly. Examining intensive care patients may be limited by their physical or intellectual capabilities during septic encephalopathy and the department’s available equipment. For this reason, patients are often sent for imaging to determine a possible cause.
“Consensus guidelines stress the relevance of fast eradication of the underlying source, although data on the choice of the best imaging strategy in septic patients are limited,” J. Pohlan, with the Department of Radiology at the Berlin Institute of Health, and co-authors wrote.
The authors referenced a previous study that examined the use of CT in focus search among critically ill surgical patients, but noted that research pertaining to its use in medical ICU patients is meager.
To better understand the application of whole-body CT in this patient demographic, researchers retrospectively analyzed 227 CT examinations from 165 septic patients. Imaging that included the chest and abdomen were classified as “body CT” examinations, and all but one of the scans were contrast enhanced
A total of 264 foci were identified in the chest (154/264), abdomen (70/264), genitourinary system (14/264) and other body regions (26/264). CT detected septic foci with a sensitivity of 75.8% and specificity of 59.7%.
After the foci were identified, the results were then compared with the final focus observed in discharge documents, where a significant agreement of 78% was noted. When patients underwent more than one CT exam, additional foci and foci progression were detected.
“The results showed that repeat CT imaging can visualize new foci in a subset of patients and also provide feedback on the success of targeted treatment of infections identified by earlier CT examinations,” the experts explained.
While the results of their study demonstrate the value of CT to rule-in sepsis or septic shock, the authors caution that it should not be used to rule out an infectious source.
You can view the detailed results of the study in Clinical Radiology.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.