1
|
Urikura A. [A Reconsideration of Fundamental Chest CT Imaging]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2021; 77:1337-1344. [PMID: 34803114 DOI: 10.6009/jjrt.2021_jsrt_77.11.1337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
2
|
Smith TB, Rubin GD, Solomon J, Harrawood B, Choudhury KR, Samei E. Local complexity metrics to quantify the effect of anatomical noise on detectability of lung nodules in chest CT imaging. J Med Imaging (Bellingham) 2018; 5:045502. [PMID: 30840750 PMCID: PMC6250496 DOI: 10.1117/1.jmi.5.4.045502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 10/23/2018] [Indexed: 12/21/2022] Open
Abstract
The purpose of this study is to (1) develop metrics to characterize the regional anatomical complexity of the lungs, and (2) relate these metrics with lung nodule detection in chest CT. A free-scrolling reader-study with virtually inserted nodules (13 radiologists × 157 total nodules = 2041 responses) is used to characterize human detection performance. Metrics of complexity based on the local density and orientation of distracting vasculature are developed for two-dimensional (2-D) and three-dimensional (3-D) considerations of the image volume. Assessed characteristics included the distribution of 2-D/3-D vessel structures of differing orientation (dubbed "2-D/3-D and dot-like/line-like distractor indices"), contiguity of inserted nodules with local vasculature, mean local gray-level surrounding each nodule, the proportion of lung voxels to total voxels in each section, and 3-D distance of each nodule from the trachea bifurcation. A generalized linear mixed-effects statistical model is used to determine the influence of each these metrics on nodule detectability. In order of decreasing effect size: 3-D line-like distractor index, 2-D line-like distractor index, 2-D dot-like distractor index, local mean gray-level, contiguity with 2-D dots, lung area, and contiguity with 3-D lines all significantly affect detectability ( P < 0.05 ). These data demonstrate that local lung complexity degrades detection of lung nodules.
Collapse
Affiliation(s)
- Taylor Brunton Smith
- Duke University, Carl E. Ravin Advanced Imaging Labs, Durham, North Carolina, United States
- Duke University, Department of Radiology, Durham, North Carolina, United States
- Duke University, Medical Physics Graduate Program, Durham, North Carolina, United States
| | - Geoffrey D. Rubin
- Duke University, Department of Radiology, Durham, North Carolina, United States
| | - Justin Solomon
- Duke University, Carl E. Ravin Advanced Imaging Labs, Durham, North Carolina, United States
- Duke University, Department of Radiology, Durham, North Carolina, United States
- Duke University, Medical Physics Graduate Program, Durham, North Carolina, United States
| | - Brian Harrawood
- Duke University, Carl E. Ravin Advanced Imaging Labs, Durham, North Carolina, United States
- Duke University, Department of Radiology, Durham, North Carolina, United States
| | - Kingshuk Roy Choudhury
- Duke University, Carl E. Ravin Advanced Imaging Labs, Durham, North Carolina, United States
- Duke University, Department of Radiology, Durham, North Carolina, United States
| | - Ehsan Samei
- Duke University, Carl E. Ravin Advanced Imaging Labs, Durham, North Carolina, United States
- Duke University, Department of Radiology, Durham, North Carolina, United States
- Duke University, Medical Physics Graduate Program, Durham, North Carolina, United States
- Duke University, Department of Biomedical Engineering, Durham, North Carolina, United States
- Duke University, Department of Electrical and Computer Engineering, Durham, North Carolina, United States
- Duke University, Department of Physics, Durham, North Carolina, United States
| |
Collapse
|
3
|
Tsai EB, Chiles C, Carter BW, Godoy MC, Shroff GS, Munden RF, Truong MT, Wu CC. Incidental Findings on Lung Cancer Screening: Significance and Management. Semin Ultrasound CT MR 2018; 39:273-281. [DOI: 10.1053/j.sult.2018.02.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
4
|
Icard B, Biscardi F, Sofi U. Demonstrating Hickam's Dictum: Metachronous Pulmonary Adenocarcinoma, Carcinoid Tumor, and Histoplasmosis. Am J Med 2017; 130:1265-1268. [PMID: 28690073 DOI: 10.1016/j.amjmed.2017.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 06/28/2017] [Accepted: 06/29/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Bradley Icard
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Carilion Clinic, Virginia Tech Carilion School of Medicine and Research Institute, Roanoke.
| | - Frank Biscardi
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Carilion Clinic, Virginia Tech Carilion School of Medicine and Research Institute, Roanoke
| | - Umar Sofi
- Section of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Carilion Clinic, Virginia Tech Carilion School of Medicine and Research Institute, Roanoke
| |
Collapse
|
5
|
Incidental and Underreported Pleural Plaques at Chest CT: Do Not Miss Them-Asbestos Exposure Still Exists. BIOMED RESEARCH INTERNATIONAL 2017; 2017:6797826. [PMID: 28656146 PMCID: PMC5474542 DOI: 10.1155/2017/6797826] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/10/2017] [Indexed: 11/22/2022]
Abstract
Pleural plaques (PPs) may be a risk factor for mortality from lung cancer in asbestos-exposed workers and are considered to be a marker of exposure. Diagnosing PPs is also important because asbestos-exposed patients should be offered a health surveillance that is mandatory in many countries. On the other hand PPs are useful for compensation purposes. In this study we aimed to evaluate the prevalence, as incidental findings, and the underreporting rate of PPs in chest CT scans (CTs) performed in a cohort of patients (1512) who underwent chest CT with a slice thickness no more than 1.25 mm. PPs were found in 76 out of 1482 patients (5.1%); in 13 out of 76 (17,1%) CTs were performed because of clinical suspicion of asbestos exposure and 5 of them (38%) were underreported by radiologist. In the remaining 63 cases (82.9%) there was no clinical suspicion of asbestos exposure at the time of CTs (incidental findings) and in 38 of these 63 patients (60.3%) PPs were underreported. Reaching a correct diagnosis of PPs requires a good knowledge of normal locoregional anatomy and rigorous technical approach in chest CT execution. However the job history of the patient should always be kept in mind.
Collapse
|
6
|
Karakose Okyaltırık F, Rezvani A, Turan S, Uysal Ö, Yakar F, Sozgen H, Ozkan NE, Akkoyunlu ME, Bayram M, Kutbay Ozcelik H, Sezer M, Guler M, Yaylım İ, Kart L. Relationship of CTLA4 and CD28 polymorphisms with lung involvement, HRCT findings and pulmonary function tests in Turkish patients with ankylosing spondylitis. CLINICAL RESPIRATORY JOURNAL 2015; 11:593-601. [DOI: 10.1111/crj.12388] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 08/11/2015] [Accepted: 09/06/2015] [Indexed: 11/26/2022]
Affiliation(s)
| | - Aylin Rezvani
- Department of Physical Therapy and Rehabilitation; Bezmialem Vakif University; Istanbul Turkey
| | - Saime Turan
- Department of Molecular Medicine; Istanbul University, Institute for Experimental Medicine Research; Istanbul Turkey
| | - Ömer Uysal
- Department of Biostatistics and Medical Informatics; Bezmialem Vakif University; Istanbul Turkey
| | - Fatih Yakar
- Department of Chest Disease; Bezmialem Vakif University; Istanbul Turkey
| | - Hatice Sozgen
- Department of Chest Disease; Bezmialem Vakif University; Istanbul Turkey
| | - Nazlı Ezgi Ozkan
- Department of Molecular Medicine; Istanbul University, Institute for Experimental Medicine Research; Istanbul Turkey
| | | | - Mehmet Bayram
- Department of Chest Disease; Bezmialem Vakif University; Istanbul Turkey
| | | | - Murat Sezer
- Department of Chest Disease; Bezmialem Vakif University; Istanbul Turkey
| | - Mustafa Guler
- Department of Physical Therapy and Rehabilitation; Bezmialem Vakif University; Istanbul Turkey
| | - İlhan Yaylım
- Department of Molecular Medicine; Istanbul University, Institute for Experimental Medicine Research; Istanbul Turkey
| | - Levent Kart
- Department of Chest Disease; Bezmialem Vakif University; Istanbul Turkey
| |
Collapse
|
7
|
Krier JB, Green RC. Management of Incidental Findings in Clinical Genomic Sequencing. ACTA ACUST UNITED AC 2015; 87:9.23.1-9.23.16. [PMID: 26439717 DOI: 10.1002/0471142905.hg0923s87] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Genomic sequencing is becoming accurate, fast, and increasingly inexpensive, and is rapidly being incorporated into clinical practice. Incidental or secondary findings, which can occur in large numbers from genomic sequencing, are a potential barrier to the utility of this new technology due to their relatively high prevalence and the lack of evidence or guidelines available to guide their clinical interpretation. This unit reviews the definition, classification, and management of incidental findings from genomic sequencing. The unit focuses on the clinical aspects of handling incidental findings, with an emphasis on the key role of clinical context in defining incidental findings and determining their clinical relevance and utility.
Collapse
Affiliation(s)
- Joel B Krier
- Genomes2People Research Program, Division of Genetics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Robert C Green
- Genomes2People Research Program, Division of Genetics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.,Broad Institute, Boston, Massachusetts
| |
Collapse
|
8
|
The incidental pulmonary nodule in a child. Part 1: recommendations from the SPR Thoracic Imaging Committee regarding characterization, significance and follow-up. Pediatr Radiol 2015; 45:628-33. [PMID: 25655369 DOI: 10.1007/s00247-014-3267-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 10/14/2014] [Accepted: 12/19/2014] [Indexed: 12/21/2022]
Abstract
No guidelines are in place for the follow-up and management of pulmonary nodules that are incidentally detected on CT in the pediatric population. The Fleischner guidelines, which were developed for the older adult population, do not apply to children. This review summarizes the evidence collected by the Society for Pediatric Radiology (SPR) Thoracic Imaging Committee in its attempt to develop pediatric-specific guidelines.Small pulmonary opacities can be characterized as linear or as ground-glass or solid nodules. Linear opacities and ground-glass nodules are extremely unlikely to represent an early primary or metastatic malignancy in a child. In our review, we found a virtual absence of reported cases of a primary pulmonary malignancy presenting as an incidentally detected small lung nodule on CT in a healthy immune-competent child.Because of the lack of definitive information on the clinical significance of small lung nodules that are incidentally detected on CT in children, the management of those that do not have the typical characteristics of an intrapulmonary lymph node should be dictated by the clinical history as to possible exposure to infectious agents, the presence of an occult immunodeficiency, the much higher likelihood that the nodule represents a metastasis than a primary lung tumor, and ultimately the individual preference of the child's caregiver. Nodules appearing in children with a history of immune deficiency, malignancy or congenital pulmonary airway malformation should not be considered incidental, and their workup should be dictated by the natural history of these underlying conditions.
Collapse
|
9
|
Jairam PM, de Jong PA, Mali WPTM, Isgum I, van der Graaf Y. Cardiovascular disease prediction: do pulmonary disease-related chest CT features have added value? Eur Radiol 2015; 25:1646-54. [PMID: 25773934 PMCID: PMC4419189 DOI: 10.1007/s00330-014-3495-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 09/16/2014] [Accepted: 11/10/2014] [Indexed: 11/30/2022]
Abstract
Objective Certain pulmonary diseases are associated with cardiovascular disease (CVD). Therefore we investigated the incremental predictive value of pulmonary, mediastinal and pleural features over cardiovascular imaging findings. Methods A total of 10,410 patients underwent diagnostic chest CT for non-cardiovascular indications. Using a case-cohort approach, we visually graded CTs from the cases and from an approximately 10 % random sample of the baseline cohort (n = 1,203) for cardiovascular, pulmonary, mediastinal and pleural findings. The incremental value of pulmonary disease-related CT findings above cardiovascular imaging findings in cardiovascular event risk prediction was quantified by comparing discrimination and reclassification. Results During a mean follow-up of 3.7 years (max. 7.0 years), 1,148 CVD events (cases) were identified. Addition of pulmonary, mediastinal and pleural features to a cardiovascular imaging findings-based prediction model led to marginal improvement of discrimination (increase in c-index from 0.72 (95 % CI 0.71–0.74) to 0.74 (95 % CI 0.72–0.75)) and reclassification measures (net reclassification index 6.5 % (p < 0.01)). Conclusion Pulmonary, mediastinal and pleural features have limited predictive value in the identification of subjects at high risk of CVD events beyond cardiovascular findings on diagnostic chest CT scans. Key Points • Incidental cardiovascular findings on routine chest CT can predict cardiovascular disease • Non-cardiovascular chest CT abnormalities are associated with cardiovascular disease • Non-cardiovascular chest CT features have limited predictive value beyond cardiovascular features Electronic supplementary material The online version of this article (doi:10.1007/s00330-014-3495-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Pushpa M Jairam
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands,
| | | | | | | | | |
Collapse
|
10
|
Dilli A, Ayaz UY, Turanlı S, Saltas H, Karabacak OR, Damar C, Hekimoglu B. Incidental extraspinal findings on magnetic resonance imaging of intervertebral discs. Arch Med Sci 2014; 10:757-63. [PMID: 25276162 PMCID: PMC4175778 DOI: 10.5114/aoms.2014.44868] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 04/18/2012] [Accepted: 06/28/2012] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION We aimed to evaluate pathological extraspinal findings and congenital anomalies/anatomical variations that were incidentally detected on the magnetic resonance imaging (MRI) scans of intervertebral discs, to find the frequencies of these incidental findings, and to emphasise the clinical importance of them. MATERIAL AND METHODS A retrospective study including 1031 consecutive patients (730 females and 301 males, with a median age of 46 years) was conducted by evaluating a total of 1106 MRI examinations of intervertebral discs. Examinations were performed with a 1.5 T MRI unit. Incidental findings were classified as pathological findings and congenital anomalies/anatomical variations. RESULTS The percentages of incidental extraspinal pathological findings and congenital anomalies/anatomical variations were 16.6% (95% confidence interval (CI): 14.4-18.8) and 3.7% (95% CI: 2.6-4.3), respectively. The percentage of incidental extraspinal pathological findings on cervical spinal MRI was 25.7% (95% CI: 20.1-31.7), thyroid nodules being the most common incidental findings. On thoracic spinal MRI (n = 19), inferior pole thyroid nodules were demonstrated as incidental extraspinal pathological findings, with a percentage of 10.5% (95% CI: 9.6-11.5). On lumbar spinal MRI, incidental pathological findings were detected with a percentage of 14.2% (95% CI: 11.9-16.6), while the percentage of congenital anomalies/anatomical variations was 4.8% (95% CI: 3.4-6.3). Eventually, 6.5% (95% CI: 2.6-9.4) of all cases with incidental extraspinal pathological findings underwent surgery. CONCLUSIONS On MRI examination of intervertebral discs, paying attention to incidentally detected pathological extraspinal findings and congenital anomalies/anatomical variations is very important due to the fact that they can alter the treatment of the patient or affect the patient's life.
Collapse
Affiliation(s)
- Alper Dilli
- Ministry of Health, Dıskapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Umit Yasar Ayaz
- Ministry of Health, Mersin Women's and Children's Hospital, Mersin, Turkey
| | - Sevim Turanlı
- Ministry of Health, Ankara Oncology Education and Research Hospital, Ankara, Turkey
| | - Hakan Saltas
- Ministry of Health, Dıskapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Osman Raif Karabacak
- Ministry of Health, Dıskapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Cagrı Damar
- Ministry of Health, Dıskapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Baki Hekimoglu
- Ministry of Health, Dıskapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
11
|
Rogers AJ, Maher CO, Schunk JE, Quayle K, Jacobs E, Lichenstein R, Powell E, Miskin M, Dayan P, Holmes JF, Kuppermann N. Incidental findings in children with blunt head trauma evaluated with cranial CT scans. Pediatrics 2013; 132:e356-63. [PMID: 23878053 DOI: 10.1542/peds.2013-0299] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Cranial computed tomography (CT) scans are frequently obtained in the evaluation of blunt head trauma in children. These scans may detect unexpected incidental findings. The objectives of this study were to determine the prevalence and significance of incidental findings on cranial CT scans in children evaluated for blunt head trauma. METHODS This was a secondary analysis of a multicenter study of pediatric blunt head trauma. Patients <18 years of age with blunt head trauma were eligible, with those undergoing cranial CT scan included in this substudy. Patients with coagulopathies, ventricular shunts, known previous brain surgery or abnormalities were excluded. We abstracted radiology reports for nontraumatic findings. We reviewed and categorized findings by their clinical urgency. RESULTS Of the 43,904 head-injured children enrolled in the parent study, 15,831 underwent CT scans, and these latter patients serve as the study cohort. On 670 of these scans, nontraumatic findings were identified, with 16 excluded due to previously known abnormalities or surgeries. The remaining 654 represent a 4% prevalence of incidental findings. Of these, 195 (30%), representing 1% of the overall sample, warranted immediate intervention or outpatient follow-up. CONCLUSIONS A small but important number of children evaluated with CT scans after blunt head trauma had incidental findings. Physicians who order cranial CTs must be prepared to interpret incidental findings, communicate with families, and ensure appropriate follow-up. There are ethical implications and potential health impacts of informing patients about incidental findings.
Collapse
Affiliation(s)
- Alexander J Rogers
- Department of Emergency Medicine, University of Michigan Hospital and Health Systems, Ann Arbor, Michigan 48109, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Krier JB, Green RC. Management of incidental findings in clinical genomic sequencing. ACTA ACUST UNITED AC 2013; Chapter 9:Unit9.23. [PMID: 23595601 DOI: 10.1002/0471142905.hg0923s77] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Genomic sequencing is becoming accurate, fast, and inexpensive, and is rapidly being incorporated into clinical practice. Incidental findings, which result in large numbers from genomic sequencing, are a potential barrier to the utility of this new technology due to their high prevalence and the lack of evidence or guidelines available to guide their clinical interpretation. This unit reviews the definition, classification, and management of incidental findings from genomic sequencing. The unit focuses on the clinical aspects of handling incidental findings, with an emphasis on the key role of clinical context in defining incidental findings and determining their clinical relevance and utility.
Collapse
Affiliation(s)
- Joel B Krier
- Harvard Medical School Genetics Training Program, Boston, MA, USA
| | | |
Collapse
|
13
|
Brown SD. Professional Norms Regarding How Radiologists Handle Incidental Findings. J Am Coll Radiol 2013; 10:253-7. [DOI: 10.1016/j.jacr.2012.10.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 10/04/2012] [Indexed: 12/21/2022]
|
14
|
Screening for lung cancer using low-dose spiral CT: 10 years later, state of the art. Radiol Med 2012; 118:51-61. [PMID: 22744348 DOI: 10.1007/s11547-012-0843-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 09/28/2011] [Indexed: 12/21/2022]
Abstract
Ten years after the first papers on this subject, this editorial represents a brief review on lung cancer screening with low-dose spiral CT. The aim is to present the main theoretical and practical problems related to lung cancer screening, the historical background and results of observational studies and the main ongoing randomised controlled trials. In particular, the National Lung Screening Trial (NLST), which was interrupted early, is discussed. The opinion of the authors is that too many questions are still awaiting an answer.
Collapse
|
15
|
Frank L, Quint LE. Chest CT incidentalomas: thyroid lesions, enlarged mediastinal lymph nodes, and lung nodules. Cancer Imaging 2012; 12:41-8. [PMID: 22391408 PMCID: PMC3335330 DOI: 10.1102/1470-7330.2012.0006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
A computed tomography (CT) incidentaloma is an incidentally detected and previously unsuspected finding or abnormality that is not related to the indication for obtaining the CT examination. The aim of this article is to review the frequency of incidentalomas on chest CT scans, discuss the potential clinical significance of the findings, and suggest guidelines for reporting, further evaluation, and follow-up, with particular focus on thyroid lesions, enlarged mediastinal lymph nodes and lung nodules.
Collapse
Affiliation(s)
- Luba Frank
- Department of Radiology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA.
| | | |
Collapse
|
16
|
Johnson DB, Powers MA, Wu S, Huang YCT. Follow-up Recommendations for Chest CT Scan Reports of Incidental Pulmonary Nodules. Chest 2012; 141:280-281. [DOI: 10.1378/chest.11-2157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
|
17
|
Casella M, Perna F, Pontone G, Dello Russo A, Andreini D, Pelargonio G, Riva S, Fassini G, Pepi M, Ballerini G, Moltrasio M, Majocchi B, Bartoletti S, Formenti A, Santangeli P, Di Biase L, Natale A, Tondo C. Prevalence and clinical significance of collateral findings detected by chest computed tomography in patients undergoing atrial fibrillation ablation. Europace 2011; 14:209-16. [PMID: 21933801 DOI: 10.1093/europace/eur300] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
AIMS Chest computed tomography (CT) scanning is increasingly used as an imaging technique in patients undergoing atrial fibrillation (AF) catheter ablation. Chest CT scans visualize organs other than the heart and collateral findings may be identified incidentally. Our study aims to assess the prevalence and clinical relevance of such collateral findings in patients undergoing AF ablation. METHODS AND RESULTS One hundred and seventy-three patients (127 males, age 59 ± 10 years) underwent chest CT scan for image integration in AF ablation. Collateral findings from visualized thoracic and upper abdominal organs were collected. Findings that required further investigations or treatment according to current guidelines were considered as clinically significant. A total of 164 collateral findings were identified in 97 (56%) patients, and most patients showed abnormalities of the lungs (67 patients, 39%). Forty-nine (28%) patients had clinically significant findings needing further investigation and 17 (10%) of them required specific treatments, including three cases (1.7 %) of lung malignancy. CONCLUSIONS Chest CT images acquired for integration in AF ablation should be read thoroughly as they may serve as a screening tool for otherwise unrecognized clinically significant conditions of the heart, lungs, or other visualized organs.
Collapse
Affiliation(s)
- Michela Casella
- Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|