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E5474. Incidental Findings in CT Scans for Pediatric Trauma Patients: A Comprehensive Systematic Review and Meta-Analysis
Authors
  1. Amir Hassankhani; University of Southern California
  2. Melika Amoukhteh; University of Southern California
  3. Ali Gholamrezanezhad; University of Southern California
Objective:
The utilization of CT scans in the assessment of pediatric trauma patients often reveals unexpected incidental findings. Addressing these findings requires a delicate balance between managing potential health risks and avoiding unnecessary interventions. This study aims to quantitatively consolidate and present the frequency and categories of incidental findings discovered in CT scans of pediatric trauma patients.

Materials and Methods:
Employing a systematic review and meta-analysis approach, an extensive literature search was conducted across PubMed, Scopus, and Web of Science databases through March 6, 2023, in accordance with established guidelines. Studies reporting pertinent outcomes were included, and pertinent data were extracted and subjected to analysis using STATA software version 17.0.

Results:
The study encompassed seven relevant studies on incidental findings within pediatric CT scans. The amalgamated rate of incidental findings was determined to be 27.10%, albeit substantial heterogeneity existed across the studies. Incidental findings were categorized into three groups. Category 1: necessitating immediate or urgent evaluation or treatment, which exhibited an aggregated occurrence rate of 10.15%. Category 2: likely benign but potentially requiring outpatient follow-up, which accounted for a rate of 32.18%. The most frequent was category 3 incidental findings at 51.44%, comprising benign anatomical variants or benign pathologic discoveries not requiring intervention. Notably, subgroup meta-analysis focusing on pediatric abdominal CT scans demonstrated a high pooled incidence of incidental findings at 47.17%, albeit with lower heterogeneity compared to the general meta-analysis.

Conclusion:
The study underscores the possibility of encountering incidental findings in pediatric trauma patients subjected to CT scans. The stratification of these findings into distinct categories equips clinicians with valuable insights for determining appropriate follow-up and management strategies.