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Current controversies in emergency room CT: could trauma total-body CT scanning improve clinical outcome?

Ludo F Beenen

In trauma patients who have sustained multiple injuries, every second counts: time is life. Immediate total-body computed tomography (TBCT) can give quick and complete radiological diagnoses for these critically ill patients. Hence, direct scanning can result in increased survival and a reduction in emergency department time. Several, mostly retrospective studies, have shown the potential of TBCT scanning in trauma patients. In these studies, TBCT appears to be associated with reduced evaluation times and decreased mortality. On the other hand, concerns have risen concerning the amount of radiation exposure in this overall relatively young population. Therefore, the need for prospective studies has been stressed recently by several authors. If immediate TBCT scanning is found to be the best imaging strategy in severely injured trauma patients, it could replace conventional imaging with selective CT in this specific group.