Diagnostic yield of urological low dose CT surveillance of individuals with spinal cord injury

Study Design : Retrospective cohort study. Objectives : To assess the diagnostic yield of low-dose surveillance CT scans of the urinary tract in individuals with spinal cord injury (SCI), with diagnostic yield defined as urological abnormalities detected with surveillance imaging warranting a medical or surgical treatment. Setting : Department of Brain and Spinal Cord Injury, Copenhagen University Hospital, Denmark. Methods : Individuals with SCI followed in the outpatient clinic were consecutively included. Inclusion criteria were age above 15 years at SCI onset and acquired SCI between 2000 and 2015. Results : A total of 107 individuals were included, 59% female. The mean age at injury was 43 years, and the mean duration of disease was 16 years. Traumatic aetiology accounted for 46%, and tetraplegia occurred in 42%. Moderate or severe renal insufficiency with onset after SCI was present in 6%. A total of 443 imaging examinations were performed, of which 96% were CT scans. A combination of surveillance and symptomatic examinations were registered. Ninety (20%) examinations showed abnormal findings, and 16 (4%) of examinations with abnormal findings resulted in treatment. Three of the 16 examinations resulting in treatment were surveillance CT scans. The three examinations were from two individuals, with one undergoing surveillance for known urological pathology. Of the abnormal surveillance CT scans 4.6% resulted in treatment. Conclusion : Surveillance CT imaging had a low diagnostic yield, with few abnormal findings leading to treatment suggesting limited benefit of surveillance urological imaging individuals with SCI.