CT - Referral Guidelines

Computerised tomography (CT) is a test that uses X-ray equipment and computer software to create pictures of the inside of the body.

The CT scanner is a ring-shaped machine. Inside the ring is an X-ray tube that produces a fan-shaped beam of X-rays. The tube rotates around your body as you lie flat, creating individual pictures that are cross-sectional ‘ slices’ throughout the body.

The images from CT are black, white and grey, as with plain X-rays, but the computer joins the slices together to give three-dimensional views. This means that a CT scan allows doctors to see the height, width and depth of something inside the body.

The images are kept in a digital format and shown on a computer screen.

• Direct access to CT Scanning following the results of another imaging investigation eg. allowing the patient to proceed directly from ultrasound to CT when further imaging is required or allowing the GP to directly refer to CT following receipt of results of imaging investigations that recommend a CT scan.
• Direct access to CT head imaging for patients with headaches according to criteria.

Criteria

CT scanning is a high radiation dose investigation, and requires careful patient selection for this reason.  Please read the following criteria carefully:

Indications for direct access CT

• Where the report of a direct access imaging investigation advises a CT scan  in order to avoid delays in the patient pathway.
• Headaches according to agreed referral criteria (see below).

Indications for referral for direct access head CT

Red flag features

• New headache with known active or potentially active malignant disease or HIV.
• New headache with persistent vomiting.
• New headache with significant focal signs or symptoms.
• New headache with papilloedema
• New headache with history compatible with raised intracranial pressure such as worse on coughing, sneezing, bending or straining, and woken up by headache in the early hours of the morning.

Non red flag headaches.

• Failure of conventional treatment for benign headaches (reasonable trial of anti-migraine drugs, Tricyclic agents and analgesic withdrawal).
• GP has a major concern that patient cannot be reassured that they do not have a brain tumour without CT scan.
• GP feels that they can manage benign headache without referral to secondary care with normal brain CT.

Referral Process

There are two ways of organising a direct access CT scan:

• via Sunquest ICE (preferable)

• by completing the referral form on the right of this page and faxing it to the hospital on fax no. 0208 401 3454.

This service is only available at Croydon University Hospital

530 London Road
Croydon
CR7 7YE
Tel: 020 8401 3000

CT enquiries:

Tel: 020 8401 3049  

xray@croydonhealth.nhs.uk

Waiting Times

The maximum waiting time is 4 weeks

Operational Manager for Diagnostic Imaging

Deanna McCready

Tel: 020 8401 3465
Email: deanna.mccready@croydonhealth.nhs.uk

Consultant Radiologist/Clinical Lead

Dr S Maheshwaran

Tel: 020 8401 3000 ext.4122
Email: satkurunathan@croydonhealth.nhs.uk