2635. Does Evaluating for Discrepancies in Abdominal US and CT Guide Intervention for Reducing Overutilization of Duplicate Exams?
Authors * Denotes Presenting Author
  1. Timothy Sherry *; Loma Linda University
  2. Eric Peters; Loma Linda University
Multiple follow up abdominal ultrasounds have been completed within 24 hours of a completed CT abdomen and pelvis examination at our institution in the past year. With the continued rise in imaging requests and increased sonographer shortages during the COVID-19 pandemic, we sought to assess the utility of follow up ultrasounds within 24 hours of a completed CT abdomen and pelvis to decrease possibly unwarranted examinations as part of a quality initiative.

Materials and Methods:
We are in the process of completing a retrospective review of all patients who underwent an abdominal ultrasound at our institution within 24 hours of completing an abdomen/pelvis CT with and/or without contrast or abdomen/pelvis angiogram (CTA) from August 2021 to August 2022. We collected data on changes in significant findings between the reports, time between completion of studies, sonographer time to complete ultrasound exam, follow up time, and if initial CT read was accurate. Statistical analysis was completed using Fisher exact test and student t-test with a p value < 0.05 considered statistically significant.

A total of 685 patients underwent an abdominal ultrasound examinations within 24 hours of completion of the initial abdomen/pelvis CT study. Of the 50 initially reviewed examinations, there was 1 significant finding that may have explained patient symptoms that was not reported on the initial CT, however, in retrospective review this finding was present on initial CT. Additionally, average scanning time to complete the ultrasound was 17.2 minutes, resulting in 196.7 work hours per year of scanning time. No significant change in patient management was noted for any of the reviewed examinations due to follow-up ultrasound results.

Multiple prior studies have already demonstrated the limited utility of abdominal and pelvic ultrasound in the setting of recently completed abdominal and pelvic CT in the setting of no emergent findings. Our preliminary results have found that short interval (<24 hour) follow up abdominal ultrasounds have limited utility in the setting of both positive and negative initial abdomen/pelvis CT examinations, with no significant change in clinical management based on the follow-up ultrasound results. We aim to complete the review of all qualifying examinations at our institution to identify predictable factors that may guide intervention to best utilize our limited resources and provide optimal patient care as part of an ongoing quality initiative project.