Incidental Findings on Cardiac Multidetector Row Computed Tomography Among Healthy Older Adults<subtitle>Prevalence and Clinical Correlates</subtitle>

Abstract

Background: With the widespread use of cardiac multidetector row computed tomography (MDCT), the issue of incidental findings is receiving increasing attention. Our objectives were to evaluate the prevalence of incidental findings discovered during cardiac MDCT scanning and to identify clinical variables associated with incidental findings. Methods: This cross-sectional analysis involved a population-based sample recruited from an integrated health care delivery system in Northern California as part of the Atherosclerotic Disease, Vascular Function and Genetic Epidemiology (ADVANCE) Study. Healthy men and women aged 60 to 69 years without diagnosed cardiovascular disease underwent cardiac MDCT for the detection and quantification of coronary artery calcification. The images were prospectively evaluated for incidental findings. Results: A total of 459 participants underwent MDCT scanning, and the overall prevalence of any incidental finding was 41%. Of the 459 participants, 105 (23%) had at least 1 incidental finding that was recommended for clinical or radiological follow-up examination, the most common of which was single or multiple pulmonary nodules (18%). Participants with and without incidental findings had comparable baseline demographics and selected clinical variables, although there were significantly fewer men and a significantly lower prevalence of the metabolic syndrome in those with incidental findings. Conclusions: Incidental findings, especially pulmonary nodules, are common in cardiac MDCT performed to assess coronary artery calcification in older healthy adults. The net risks and benefits of looking for noncardiac abnormalities during cardiac MDCT should be rigorously evaluated.

Thoracic malignancies and pulmonary nodules in patients under evaluation for transcatheter aortic valve implantation (TAVI): Incidence, follow up and possible impact on treatment decision

“…SPN of at least 5 mm size were found in 18% in the initial study collective. This ratio corresponds well to other published studies, which reported incidence rates ranging from 3.5% to 28% [9,[34][35][36][37][38][39].…”

Accuracy of Clinicians and Models for Estimating the Probability That a Pulmonary Nodule Is Malignant

“…Nearly one in five cardiac computed tomography (CT) scans has been reported to show an incidental pulmonary nodule (1). In addition, the National Lung Screening Trial reported that 39% of high-risk smokers who underwent annual CT screening had a least one positive screening examination (2).…”

Additional value cardiac computed tomography – is it worth assessing more than coronary arteries?

“…Przypadkowo znalezione patologie pozasercowe mogą być odpowiedzialne za dolegliwości pacjenta i mogą mieć wpływ na dalsze postę-powanie lecznicze. Częstość wykrywania patologii pozasercowych w trakcie badania naczyń wieńcowych wynosi 15-90% [9][10][11][12][13][14][15][16][17], natomiast patologie istotne, które wymagają dalszej diagnostyki lub leczenia, stwierdzane są w 4,2-38% przypadków [9]. Tak duże różnice w częstości wykrywania patologii pozasercowych związane są przede wszystkim z typem skanera, na którym wykonywane były badania, jak również z zakresem badania (tętnice wieńcowe vs pomosty wieńcowe) (tab.…”

“…Jedną z najczęstszych patologii pozasercowych wykrywanych podczas badania CT naczyń wieńcowych są guzki w płucach. Ich częstość określana jest na 5-20% [15,18], najczęściej są to guzki poniżej 1 cm (9,3-19%), guzki większe od 1 cm wykrywane są w 0,6-2,4% przypadków [9,18] (ryc. 12.).…”