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Incidental Non-cardiac Findings in Coronary Computed Tomography Angiography: Is it Worth Reporting?

Authors
  • Ramanathan, Subramaniyan1, 2
  • Ladumor, Sushila B3, 2
  • Francis, Willington4
  • Allam, Abdelnasser A4, 5
  • Alkuwari, Maryam4
  • 1 Departments of Clinical Imaging, Al Wakra Hospital, Hamad Medical Corporation, Qatar. , (Qatar)
  • 2 Department of Radiology, Weill Cornell Medicine, Doha, Qatar. , (Qatar)
  • 3 Departments of Clinical Imaging, Hamad General Hospital, Hamad Medical Corporation, Qatar. , (Qatar)
  • 4 Departments of Clinical Imaging, Heart Hospital, Hamad Medical Corporation, Qatar. , (Qatar)
  • 5 Department of Radiology, Al Azhar Faculty of Medicine, Cairo, Egypt. , (Egypt)
Type
Published Article
Journal
Journal of clinical imaging science
Publication Date
Jan 01, 2019
Volume
9
Pages
40–40
Identifiers
DOI: 10.25259/JCIS_41_2019
PMID: 31538038
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The objectives of this study were to estimate the prevalence and significance of incidental non-cardiac findings (INCFs) in coronary computed tomography angiography (CCTA) using a dual-source multidetector computed tomography. Retrospective review of all CCTA studies performed over a time period for various indications was included in the study. After exclusions, CCTA of 1713 patients was evaluated by two experienced cardiac radiologists for non-cardiac abnormalities in the full field-of-view limited contrast chest series. The scans were acquired from the level of the carina to just below the diaphragm. INCFs were classified into three categories: Significant, indeterminate, and insignificant findings based on their clinical impact and availability of prior imaging and clinical details. The study cohort consisted of 1123 males (mean age of 58 years) and 590 females (mean age of 64 years). INCFs were seen in 600 patients of 1713 patients. A total of 812 INCFs (47.5%) were found in 1713 patients. Of those, 568 (70%) were considered insignificant, 205 (25.2%) indeterminate, and 39 significant findings (4.9%). The prevalence of significant findings was 2.3%. Among the 39 significant findings, after correlating with clinical details and other imaging, nine were really significant findings (0.5%) and out of this, four turned out to be cancers (0.2%). Large number of INCFs can be found in CCTA with majority of them being insignificant or of minimal clinical impact. Although the proportion of significant findings is small and may not be cost beneficial, it is prudent to evaluate all the available data and to make appropriate classification of INCFs which can help in further management.

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