Characteristics of Chest Lesions Missed on Neck CT Interpretations

Abstract

Purpose: The purpose of this study was to identify the characteristics of chest lesions that are missed in interpretations of neck computed tomography (CT) scans. Materials and Methods: A total of 240 consecutive neck CT scans were retrospectively analyzed to determine whether chest lesions were included or not. All missed chest lesions, which had not been described on neck CT reports, were recorded, and classified according to their clinical significance (insignificant, indeterminate, or significant) and awareness (known or unknown) at the time of CT interpretation, and their radiologic patterns were analyzed. Results: Eighty seven (36.3%) of 240 neck CT scans had 105 chest lesions, and 88 of these were not described on the neck CT reports. Thirty seven clinically known or insignificant lesions were excluded, resulting in a miss rate for chest lesions of 35.2% (37/105), with six of these (5.7%) being potentially significant. The most common location of missed chest lesions was the lung (56/88, 63.6%), and 45 (80.4%) of these missed lung lesions were visualized only with lung window settings. Conclusion: Chest lesions were common and frequently missed on neck CT interpretations. When reviewing neck CT scans, a special attention should be given to lung lesions by using lung window settings.