Incidental extra-cardiac findings on clinical CMR

Irwin, Richard Bruce; Newton, Tom; Peebles, Charles; Borg, Alexander; Clark, David G.; Miller, Chris; Abidin, Nik; Greaves, Melanie; Schmitt, Matthias

doi:10.1093/ehjci/jes133

Cited by 27 publications

(35 citation statements)

References 15 publications

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“…3). The prevalence of IF in our study population is greater than that in several studies looking at the rate in clinically indicated CMR [10, 11, 13]. In fact, it is more than seven times greater than the rate reported by Chan in a clinically robust study of 1534 consecutive clinically indicated CMR studies (59.0 % vs 7.6 %) [10].…”

Section: Discussioncontrasting

confidence: 59%

Research cardiac magnetic resonance imaging in end stage renal disease - incidence, significance and implications of unexpected incidental findings

Rutherford

Weir‐McCall

Patel³

et al. 2016

Eur Radiol

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ObjectivesLeft ventricular mass (LVM) at cardiac magnetic resonance imaging (CMR) is a frequent end point in clinical trials in nephrology. Trial participants with end stage renal disease (ESRD) may have a greater frequency of incidental findings (IF). We retrospectively investigated prevalence of IF in previous research CMR and reviewed their subsequent impact on participants.MethodsBetween 2002 and 2006, 161 ESRD patients underwent CMR in a transplant assessment study. Images were used to assess LV mass and function. In the current study a radiologist reviewed the scans for IF. Review of patient records determined the subsequent clinical significance of IF.ResultsThere were 150 IF in 95 study participants. Eighty-four (56 %) were new diagnoses. One hundred and two were non-cardiac. Fifteen were suspicious of malignancy. There was a clinically significant IF for 14.9 % of the participants. In six cases earlier identification of an IF may have improved quality of life or survival.ConclusionsWithout radiology support clinically important IF may be missed on CMR. Patients undergoing CMR in trials should be counselled about the frequency and implications of IF. Patients with ESRD have a higher prevalence of IF than reported in other populations. Nephrology studies require mechanisms for radiologist reporting and strategies for dealing with IF.Key Points • Incidental findings on research cardiac magnetic resonance imaging can have significant consequences. • We considered incidental findings in historical renal cardiac resonance imaging clinical trials. • Incidental findings are common and important in the chronic kidney disease population. • Without radiology support, clinically significant incidental findings may be missed on imaging. • Study protocols, approvals and consent processes should take account of possible findings.

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Section: Discussioncontrasting

confidence: 59%

Research cardiac magnetic resonance imaging in end stage renal disease - incidence, significance and implications of unexpected incidental findings

Rutherford

Weir‐McCall

Patel³

et al. 2016

Eur Radiol

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“…Mean age and sex ratio were not different across studies. Ten studies used 1.5T scanners, one study used both 1.5 and 3T scanners, and one did not report field strength . MR sequences used in the studies are summarized in Table .…”

Section: Resultsmentioning

confidence: 99%

“…MR sequences used in the studies are summarized in Table . Two studies were prospective, nine retrospective, and one did not specify prospective or retrospective design . Seven studies were based on MR images review, four were based on MR reports review, and one on both .…”

Section: Resultsmentioning

confidence: 99%

Incidental extracardiac findings on cardiac MR: Systematic review and meta-analysis

Dunet

Schwitter

Meuli

2015

J. Magn. Reson. Imaging

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“…However, it is noteworthy that this study was carried out on well, asymptomatic patients for research purposes, whereas six out of the seven previously published studies have looked for CSECFs in patients having clinically indicated MRI scans. 2,3,[5][6][7][8] In some instances these patients were intubated, which would increase the chance of finding pathology such as atelectasis, pleural effusions and pneumonias which were often the most common findings. Dewey et al 4 found a prevalence of 2% CSECFs in a research group of older patients, mean age 63 years.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of CSECFs reported in previous studies is between 1.1% and 21%. [2][3][4][5][6][7][8] Whilst these studies have looked at the prevalence in the general population, no study has looked specifically at an HIV-positive population.…”

Section: Introductionmentioning

confidence: 99%

Clinically significant extra-cardiac findings in asymptomatic HIV-positive men undergoing cardiac magnetic resonance imaging

et al. 2014

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Increased research-based imaging has led to an increase in clinically significant extra-cardiac findings. HIV patients are at increased risk of having polypathology at a younger age; therefore, it may be hypothesised that they would have more incidental findings on imaging. We reviewed the magnetic resonance imaging results of 169 HIV-positive and 40 HIV-negative, clinically well volunteers undergoing cardiac magnetic resonance imaging scanning to assess the prevalence of subclinical cardiac pathology. This sub-study assessed the prevalence of clinically significant extra-cardiac findings. Associated risk factors were assessed and clinical follow-up and outcome were ascertained. Of the HIV-positive study group, 12/169 (7.1%) vs. 1/40 (2.5%) control patients had a clinically significant extra-cardiac finding which warranted further radiological or clinical intervention (p = 0.28). A total of three out of 169 (1.1%) were highly clinically significant findings. On logistic regression analysis, age was the only significant contributing factor (p = 0.049); no HIV-associated factors were found to be significant. The prevalence of clinically significant extra-cardiac findings of 7.1% in this HIV-positive cohort is comparable to the prevalence found in previous studies carried out on an older, sicker general population. This highlights the need for planning for unexpected outcomes and also the high rate of clinically significant findings in a seemingly well HIV-positive population.

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Incidental extra-cardiac findings on clinical CMR

Cited by 27 publications

References 15 publications

Research cardiac magnetic resonance imaging in end stage renal disease - incidence, significance and implications of unexpected incidental findings

Research cardiac magnetic resonance imaging in end stage renal disease - incidence, significance and implications of unexpected incidental findings

Incidental extracardiac findings on cardiac MR: Systematic review and meta-analysis

Clinically significant extra-cardiac findings in asymptomatic HIV-positive men undergoing cardiac magnetic resonance imaging

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