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Title: Diagnostic utility of whole body CT scanning in patients with unexplained weight loss
Authors: Goh Y.
Dan Y.Y.
Chua W.
Jagmohan P.
Lee J.K.-T.
Thian Y.L. 
Keywords: iohexol
tumor marker
fluorodeoxyglucose f 18
body weight loss
cohort analysis
contrast enhancement
controlled study
diagnostic accuracy
diagnostic test accuracy study
diagnostic value
follow up
incidental finding
major clinical study
physical examination
predictive value
retrospective study
sensitivity and specificity
unexplained weight loss
whole body CT
evaluation study
middle aged
very elderly
whole body imaging
x-ray computed tomography
young adult
Aged, 80 and over
Fluorodeoxyglucose F18
Middle Aged
Predictive Value of Tests
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed
Weight Loss
Whole Body Imaging
Young Adult
Issue Date: 2018
Citation: Goh Y., Dan Y.Y., Chua W., Jagmohan P., Lee J.K.-T., Thian Y.L. (2018). Diagnostic utility of whole body CT scanning in patients with unexplained weight loss. PLoS ONE 13 (7) : e0200686. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: Background Unexplained weight loss is a non-specific complaint with myriad potential etiologies. Increasingly, whole body CT studies are being performed in patients with unexplained weight loss to exclude organic etiologies such as malignancy. Our study aims to assess the diagnostic accuracy and yield of whole body CT in these patients. Methods and materials Patients who had a whole body CT scan for investigation of unexplained weight loss as their primary complaint from 2009–2012 were retrospectively reviewed. CT scans were classified into 4 categories: (1) Definite/highly suspicious for underlying organic cause (2) Indeterminate for underlying organic cause (3) No findings accounting for weight loss and only incidental findings and (4) Normal study. Scan findings were correlated with the final diagnosis after all investigations. Univariate logistic regression was performed to determine associations between patient’s baseline variables and positive CT scan findings. Results Of 301 eligible patients during the study period, 101 patients were excluded due to known history of malignancy, inadequate follow-up or inadequate scan technique. 200 patients were included in the final analyses. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT for organic pathology were 72.0%, 90.7%, 87.0%, 78.9% and 82.0% respectively. Additional symptoms, abnormal physical examinations, anemia, and raised tumor markers were significantly correlated with positive CT findings. Overall, the diagnostic yield of whole body CT scan for patients with unexplained weight loss was 33.5%. Conclusions Whole body CT imaging may be a useful investigation for the noninvasive workup of patients with unexplained weight loss, with diagnostic yield of 33.5% and good sensitivity, specificity, positive and negative predictive values for organic etiologies. © 2018 Goh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Source Title: PLoS ONE
ISSN: 19326203
DOI: 10.1371/journal.pone.0200686
Rights: Attribution 4.0 International
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