Computed tomography frequency and power injection utilization for a cohort cancer patients with arm ports

Objectives: The goals of this study were to follow a cohort of patients with breast and colon malignancies to determine the frequency of follow-up Computed Tomography (CT) and arm port power injection for CT imaging over a one-year period. Power injection capability of a venous access device is a desired feature for patients who require intravenous contrast agents for CT. Materials and methods: All patients had been randomized to receive a power injectable or non-power injectable port as part of a clinical trial. All the patients were enrolled with the provincial Cancer Agency and all had their CT images acquired and stored in a single, provincial, Picture Archive and Communication System (PACS). A review of the annual number of CTs was performed. Only patients with breast and colon cancer were analyzed for CT utilization. All power injectable ports were evaluated for utilization for follow-up CT. Results: In the one-year period after their port was implanted, patients with colon cancer (n=77) underwent a greater number of CT studies than patients with breast cancer (n=75); 3.06 vs. 1.08 scans per patient (p<0.001). The number of CT studies performed increased with an increasing stage of cancer. The power injectable arm port was used to acquire contrast enhanced images in 114 of 241 (47%) CT studies. The use of the port for power injection of contrast agent for CT was affected by whether the CT was performed at a rural or urban location. Conclusion: A power injectable port may not be needed for patients with more favorable stages of breast and colon due to the generally low utilization of CT for follow-up. Additionally, it was apparent that the ability to access the device for power injection, based upon local expertise, was a major factor in utilization of the power injection feature.