Obesity in Radiology: Increasing incidence of obesity and its impact on diagnostic Ultrasound services.

Congress:

ECR 2018

Poster Number:

C-1250

Type:

Scientific Exhibit

Keywords:

Quality assurance, Cirrhosis, Artifacts, Decision analysis, Ultrasound, Ultrasound physics, Gastrointestinal tract, Abdomen

Authors:

C. E. O'Brien, J. Duignan, A. C. O'Brien, E. J. Heffernan, A. Weir; Dublin/IE

DOI:

10.1594/ecr2018/C-1250

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-1250

Fig. 1: Normal Liver Ultrasound Image in patient with normal BMI.

Fig. 2: US liver impacted by severe obesity. The beam is heavily attenuated by the...

Fig. 3: Rate of US Abdomen and liver that were limited by BMI (%) blue and proportion...

Aims and objectives

The aim of this study is to assess impact of obesity on the delivery of ultrasound (US) services in our institution by retrospective analysis the effect of obesity on image quality, as determined from dictated radiology reports between 2008 and 2017. The World Health Organization define obesity as a body mass index (BMI) of 30 or more (1, 2) with a BMI of 40 or more consistent with morbid obesity (3). The BMI is calculated by dividing the weight in kilograms by the square of...

Methods and materials

We performed a retrospective review of radiology reports for US Abdomen and US Liver performed during the first 2 weeks in April from 2008 to 2017. All radiology reports of ultrasound abdomen and ultrasound liver that contained the following phrases “obese” “obesity” “BMI” “bmi” “body mass index” and “habitus” that were performed during inclusion period were included. Only reports of studies performed during the first 2 weeks of April were chosen to narrow down the scope of the study. This particular time period was chosen...

Results

The total number of examinations performed during the study period was 2459, with a mean of 246(min 150 max 345). The total number of examinations that were limited due to obesity was 103 with a mean of 10 (min 4 max 23). The rate of examinations which were effected by obesity over the 10 years was 4%. The annual rate increased from 2.4% in 2008 to 9% in 2017 with the associated trend demonstrated in the attached graph (figure 3). There was a significant increase...

Conclusion

Our results confirm that an increasing number of US studies are substandard due to the effects of patient obesity. This is troubling for several different reasons. From a patient point of view this may result in the need for a follow up examination with potentially avoidable radiation, may result in a potential miss or cause unnecessary anxiety for the patient by decreasing the diagnostic power of the study. From a service perspective this equates to an increased number of scans which could have been avoided,...

Personal information

References

Organization WWH. WHO. Obesity: preventing and managing the global epidemic. WHO Tech Rep Ser. 2000;894. 2. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary. Expert Panel on the Identification, Evaluation, and Treatment of Overweight in Adults. Am J Clin Nutr. 1998;68(4):899-917. 3. Noël PH, Pugh JA. Management of overweight and obese adults. BMJ Br Med J. 2002;325(7367):757-761. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1124275/. 4. Abarca-Gómez L, Abdeen ZA, Hamid ZA, et al. Worldwide trends in body-mass index, underweight, overweight, and obesity from...