Common Incidental Findings on Cardiac CT: a Systematic Review

Kay, Fernando Uliana; Canan, Arzu; Abbara, Suhny

doi:10.1007/s12410-019-9494-4

Cited by 10 publications

(18 citation statements)

References 76 publications

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“…The five most commonly reported incidental findings were lung nodules or masses, lung parenchymal changes, lymphadenopathy, emphysema and liver nodules or cysts. Of note, CAC was seen in 42% of these patients, which is similar to the 37.5% witnessed in our cohort [40].…”

Section: Original Articlesupporting

confidence: 89%

“…Various other studies have investigated the incidence of incidental findings depicted in CT scans for various conditions such as aortic dissection [35], medical check-up [36], aortic valve stenosis [37], coronary artery disease [38], acute flank pain [14] and upper limb vascular disease [39], and on cardiac CT [40]. Prabhakar assessed incidental findings during evaluation for aortic dissection in the emergency department in 370 patients with a mean age of 63 years [35].…”

Section: Original Articlementioning

confidence: 99%

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Incidental findings during computed tomographic angiography diagnostic work-up in patients with arteriogenic erectile dysfunction

Schönhofen¹,

Mohan

Schumacher

et al. 2019

Swiss Med Wkly

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AIM: To analyse the incidental findings during computed tomographic angiography (CTA) diagnostic work-up in patients with arteriogenic erectile dysfunction (ED). PATIENTS AND METHODS:The medical records of all patients with suspected arteriogenic ED were entered into a database. Risk factors and underlying comorbidities were also collected. Pathological CTA findings were extracted from the CT readings and entered into the database. Incidental findings on CTA were classified as those requiring immediate medical treatment, requiring deferred medical treatment or of no clinical importance. RESULTS: A total of 200 patients underwent CTA for suspected arteriogenic ED. Mean patient age was 59.6 ± 11.7 years. Of these, 181 patients (90.5%) had obstructions of erection-related arteries. In 168 patients (84.0%), CTA showed multiple incidental pathological findings. Eightyfive of 200 patients (42.5%) exhibited incidental findings requiring immediate further medical workup and/or treatment: coronary artery calcification was diagnosed in 75/ 200 (37.5%), aorto-iliac aneurysms in 8/200 (4%) of patients and incidentally detected embolism in 1/200 patient. Pancreatic and liver tumours were less frequent (incidence 1.5% and 1%, respectively). Incidental findings requiring deferred medical workup and/or treatment were detected in 175/200 patients (87.5%). The findings with the highest prevalence were liver steatosis followed by colon diverticulosis and prostate hyperplasia. Findings of little to no clinical importance were reported in 117 (58.5%) patients. These included uncomplicated renal cysts, spinal degeneration and renal vascular anomalies. Almost every second patient presenting with ED had an incidental finding which required immediate treatment. CONCLUSIONS: Incidental findings not directly related to ED were common among patients undergoing CTA scans for suspected arterial obstructions. Coronary artery calcification was the leading finding requiring further medical workup and/or treatment. Thus, the benefit of CTA investigations extends beyond the anatomic description of arterial obstructions of erection-related arteries.

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Section: Original Articlesupporting

confidence: 89%

Section: Original Articlementioning

confidence: 99%

Incidental findings during computed tomographic angiography diagnostic work-up in patients with arteriogenic erectile dysfunction

Schönhofen¹,

Mohan

Schumacher

et al. 2019

Swiss Med Wkly

View full text Add to dashboard Cite

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“…Results from previous studies report a wide range in prevalence of IFs, depending on the patient population and type of medical imaging. A systematic review reported a median extracardiac IF occurrence on CCT of 45% (range 7–100%) [ 19 ]. The most common IFs were lung nodules or masses, lung parenchymal changes, lymphadenopathy, emphysema and liver nodules or cysts.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, follow-up was required in 9.9% of all women, and 32.1% of the locally performed follow-up yielded a clinically relevant finding. In the systematic review of Kay et al (2019), they found a median prevalence of only potentially clinically significant extracardiac IFs of 17% (range 1–67%) [ 19 ]. Although most IFs are benign, their discovery often causes a cascade of testing that is costly and exposes patients to additional and potentially unnecessary radiation.…”

Section: Discussionmentioning

confidence: 99%

Incidental findings on coronary computed tomography in women with selected reproductive disorders

Ham

Zwol-Janssens²,

Velthuis³

et al. 2022

Insights Imaging

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Objective To determine the prevalence of incidental findings (IFs) on coronary computed tomography (CCT) in women aged 45–55 years and previously diagnosed with reproductive disorders such as polycystic ovary syndrome (PCOS), premature ovarian insufficiency (POI) or preeclampsia (PE). Methods A total of 486 middle-aged women with PCOS (n = 101), POI (n = 97) or a history of PE (n = 288) underwent a CCT as part of a prior prospective study. IFs were categorized by their significance (minor, moderate and major). Follow-up information was collected from patients’ records. To investigate the impact of different field of views (FOVs), a subset of scans was analyzed in full FOV and small FOV. Results In 96/486 (19.8%) women, one or more IFs were detected, of which 54/486 (11.1%) were classified as moderate/major and 48/486 (9.9%) required follow-up. A moderate/major IF was detected in 16/101 (15.9%) women with PCOS, 13/97 (13.4%) women with POI and 25/288 (8.7%) women with a history of PE. In 78 women with an IF detected in the full FOV, the IF was still visible in 60 (76.9%) women in the small FOV. In the full FOV, 46 women required follow-up, but using the small FOV this was reduced to 30 women. Conclusion Using CCT as a cardiovascular disease screening tool in women with selected reproductive disorders increases the probability of detecting IFs that can cause anxiety and may generate extra costs, but can also reveal clinically relevant findings. Using a small FOV centered around the heart resulted in a lower prevalence of IFs and required less follow-up.

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“…The NCF of CTCA have been previously investigated in prospective and retrospective cohort studies with greatly varying proportions of incidental finding in scans [2][3][4][5][6][7][8][9][10][11][12][13][14][15] . A systematic review of all forms of cardiac CT found NCF in 7%-100% of studies included 16 . The most common findings in previous studies have been respiratory, in particular lung nodules.…”

Section: Introductionmentioning

confidence: 99%

Incidental findings on computed tomography coronary angiography and its impact on respiratory services in a United Kingdom district general hospital

et al. 2020

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Background: Computed tomography coronary angiography is used to assess for coronary artery disease but can also pick up non-cardiac pathology. Previous studies have assessed the frequency of non-cardiac pathology. We investigated the non-cardiac findings and resulting follow up in a District General Hospital. Methods: All computed tomography coronary angiography scans for 1 year were retrospectively collected. Basic demographics and the non-cardiac findings were recorded from electronic health records. The significant respiratory findings and the respiratory follow up of these non-cardiac findings were recorded. Results: A total of 503 scans were carried out in one year. Of these scans, 24% had non cardiac findings present. Older patients were more likely to have non cardiac findings. The most common non cardiac findings were lung nodules, emphysema and hiatus hernias. Significant respiratory findings were present in 35 cases, which generated 24 episodes of respiratory follow up. Some patients who met criteria for follow up had not been referred. Conclusions: Non cardiac findings are common on computed tomography coronary angiography and in our hospital these findings led to significant follow up in respiratory services.

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Common Incidental Findings on Cardiac CT: a Systematic Review

Cited by 10 publications

References 76 publications

Incidental findings during computed tomographic angiography diagnostic work-up in patients with arteriogenic erectile dysfunction

Incidental findings during computed tomographic angiography diagnostic work-up in patients with arteriogenic erectile dysfunction

Incidental findings on coronary computed tomography in women with selected reproductive disorders

Incidental findings on computed tomography coronary angiography and its impact on respiratory services in a United Kingdom district general hospital

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