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The role of computed tomography in the screening of patients presenting with symptoms of an intracranial tumour

  • Original Article - Brain Tumors
  • Published:
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Abstract

Background

To improve the quality of care for brain cancer patients, the Danish Ministry of Health has set standards for the diagnosis and treatment. When a patient is suspected of having a malignant tumour involving the brain, it is required that a magnetic resonance imaging of the cerebrum (MRI-C) be obtained within seven calendar days of referral from a primary care provider. This standard has the potential to consume MR imaging time that might otherwise be used for evaluation or treatment monitoring of other patients. This study primarily aims to assess the sensitivity of computed tomography of the brain (CT-C) for the detection of intracranial tumour as the initial diagnostic imaging.

Methods

This is a single-center retrospective study of patients referred to the IBCP with brain cancer suspicion. The average follow-up was 37 months. All included patients underwent a CT-C scan and subsequently a MRI-C if deemed necessary. The study population was divided into two groups based on the findings: tumour versus non-tumour. Sensitivity and specificity of the CT-C was calculated.

Results

Eight hundred seventeen patients were included. Median age was 55 years and 50% were male. CT-C had a sensitivity of 98.5% and a specificity of 98.4%. The overall mortality rate was 7% in the non-tumour group and 58% in the tumour group over the course of the study period. The tumour group was on average older compared to the non-tumour group (65 years [55–75 years] vs 52 years [38–65 years]) p < .001). The only symptom associated with brain tumour was the presence of a focal deficit (p = .002).

Conclusion

This study shows that CT-C scans are highly sensitive and specific and can be used as the primary screening tool for patients referred with a suspicion for brain cancer.

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Abbreviations

CT-C:

Computed tomography of the brain

EPJ:

Electronic patient journal

IBCP:

Initial brain cancer pathway

ICP:

The Danish integrated cancer pathway

MRI-C:

Magnetic resonance imaging of the cerebrum

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Authors and Affiliations

  1. Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark

    Sharri Junadi Mortensen, Shima Naebi Bjerrum, Stine Frost Hedegaard & Gorm von Oettingen

  2. Department of Neurology, Aarhus University Hospital, Aarhus, Denmark

    Sharri Junadi Mortensen, Stine Frost Hedegaard & Hanne Gottrup

  3. Institute of Neuroradiology, Charité Universitätsmedizin, Berlin, Germany

    Anna Tietze

Authors
  1. Sharri Junadi Mortensen
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  2. Shima Naebi Bjerrum
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  3. Stine Frost Hedegaard
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  4. Anna Tietze
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  5. Hanne Gottrup
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  6. Gorm von Oettingen
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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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For this type of study, formal consent is not required.

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None of the people involved have any personal or institutional financial interest in drugs, materials, or devices described in this submission. Nothing to disclose.

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Mortensen, S.J., Bjerrum, S.N., Hedegaard, S.F. et al. The role of computed tomography in the screening of patients presenting with symptoms of an intracranial tumour. Acta Neurochir 160, 667–672 (2018). https://doi.org/10.1007/s00701-018-3478-z

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  • DOI: https://doi.org/10.1007/s00701-018-3478-z

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