Incidental chest findings on coronary CT angiography: a pictorial essay and management proposal
ABSTRACT Many health systems have been using coronary CT angiography (CCTA) as a first-line examination for ischaemic heart disease patients in various countries. The rising number of CCTA examinations has led to a significant increase in the number of reported incidental extracardiac findings, main...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Pneumologia e Tisiologia
2022-05-01
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| Series: | Jornal Brasileiro de Pneumologia |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132022000400700&tlng=pt |
| _version_ | 1818204536129454080 |
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| author | Erique Pinto Diana Penha Bruno Hochhegger Colin Monaghan Edson Marchiori Luís Taborda-Barata Klaus Irion |
| author_facet | Erique Pinto Diana Penha Bruno Hochhegger Colin Monaghan Edson Marchiori Luís Taborda-Barata Klaus Irion |
| author_sort | Erique Pinto |
| collection | DOAJ |
| description | ABSTRACT Many health systems have been using coronary CT angiography (CCTA) as a first-line examination for ischaemic heart disease patients in various countries. The rising number of CCTA examinations has led to a significant increase in the number of reported incidental extracardiac findings, mainly in the chest. Pulmonary nodules are the most common incidental findings on CCTA scans, as there is a substantial overlap of risk factors between the population seeking to exclude ischaemic heart disease and those at risk of developing lung cancer (i.e., advanced age and smoking habits). However, most incidental findings are clinically insignificant and actively pursuing them could be cost-prohibitive and submit the patient to unnecessary and potentially harmful examinations. Furthermore, there is little consensus regarding when to report or actively exclude these findings and how to manage them, that is, when to trigger an alert or to immediately refer the patient to a pulmonologist, a thoracic surgeon or a multidisciplinary team. This pictorial essay discusses the current literature on this topic and is illustrated with a review of CCTA scans. We also propose a checklist organised by organ and system, recommending actions to raise awareness of pulmonologists, thoracic surgeons, cardiologists and radiologists regarding the most significant and actionable incidental findings on CCTA scans. |
| first_indexed | 2024-12-12T03:42:48Z |
| format | Article |
| id | doaj.art-4aefee746f02467c8a5e705782f2d537 |
| institution | Directory Open Access Journal |
| issn | 1806-3756 |
| language | English |
| last_indexed | 2024-12-12T03:42:48Z |
| publishDate | 2022-05-01 |
| publisher | Sociedade Brasileira de Pneumologia e Tisiologia |
| record_format | Article |
| series | Jornal Brasileiro de Pneumologia |
| spelling | doaj.art-4aefee746f02467c8a5e705782f2d5372022-12-22T00:39:38ZengSociedade Brasileira de Pneumologia e TisiologiaJornal Brasileiro de Pneumologia1806-37562022-05-0148410.36416/1806-3756/e20220015Incidental chest findings on coronary CT angiography: a pictorial essay and management proposalErique Pintohttps://orcid.org/0000-0002-6648-9270Diana Penhahttps://orcid.org/0000-0002-3358-6875Bruno Hochheggerhttps://orcid.org/0000-0003-1984-4636Colin Monaghanhttps://orcid.org/0000-0002-5300-0229Edson Marchiorihttps://orcid.org/0000-0001-8797-7380Luís Taborda-Baratahttps://orcid.org/0000-0001-6649-8890Klaus Irionhttps://orcid.org/0000-0002-7860-7879ABSTRACT Many health systems have been using coronary CT angiography (CCTA) as a first-line examination for ischaemic heart disease patients in various countries. The rising number of CCTA examinations has led to a significant increase in the number of reported incidental extracardiac findings, mainly in the chest. Pulmonary nodules are the most common incidental findings on CCTA scans, as there is a substantial overlap of risk factors between the population seeking to exclude ischaemic heart disease and those at risk of developing lung cancer (i.e., advanced age and smoking habits). However, most incidental findings are clinically insignificant and actively pursuing them could be cost-prohibitive and submit the patient to unnecessary and potentially harmful examinations. Furthermore, there is little consensus regarding when to report or actively exclude these findings and how to manage them, that is, when to trigger an alert or to immediately refer the patient to a pulmonologist, a thoracic surgeon or a multidisciplinary team. This pictorial essay discusses the current literature on this topic and is illustrated with a review of CCTA scans. We also propose a checklist organised by organ and system, recommending actions to raise awareness of pulmonologists, thoracic surgeons, cardiologists and radiologists regarding the most significant and actionable incidental findings on CCTA scans.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132022000400700&tlng=ptIncidental findingsCardiac-gated imaging techniquesCoronary angiographyLung neoplasms |
| spellingShingle | Erique Pinto Diana Penha Bruno Hochhegger Colin Monaghan Edson Marchiori Luís Taborda-Barata Klaus Irion Incidental chest findings on coronary CT angiography: a pictorial essay and management proposal Jornal Brasileiro de Pneumologia Incidental findings Cardiac-gated imaging techniques Coronary angiography Lung neoplasms |
| title | Incidental chest findings on coronary CT angiography: a pictorial essay and management proposal |
| title_full | Incidental chest findings on coronary CT angiography: a pictorial essay and management proposal |
| title_fullStr | Incidental chest findings on coronary CT angiography: a pictorial essay and management proposal |
| title_full_unstemmed | Incidental chest findings on coronary CT angiography: a pictorial essay and management proposal |
| title_short | Incidental chest findings on coronary CT angiography: a pictorial essay and management proposal |
| title_sort | incidental chest findings on coronary ct angiography a pictorial essay and management proposal |
| topic | Incidental findings Cardiac-gated imaging techniques Coronary angiography Lung neoplasms |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132022000400700&tlng=pt |
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