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Incidental chest findings on coronary CT angiography: a pictorial essay and management proposal

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...

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Autores principales: Pinto, Erique, Penha, Diana, Hochhegger, Bruno, Monaghan, Colin, Marchiori, Edson, Taborda-Barata, Luís, Irion, Klaus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Pneumologia e Tisiologia 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9064655/
https://www.ncbi.nlm.nih.gov/pubmed/35584528
http://dx.doi.org/10.36416/1806-3756/e20220015
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author Pinto, Erique
Penha, Diana
Hochhegger, Bruno
Monaghan, Colin
Marchiori, Edson
Taborda-Barata, Luís
Irion, Klaus
author_facet Pinto, Erique
Penha, Diana
Hochhegger, Bruno
Monaghan, Colin
Marchiori, Edson
Taborda-Barata, Luís
Irion, Klaus
author_sort Pinto, Erique
collection PubMed
description 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.
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spelling pubmed-90646552022-05-06 Incidental chest findings on coronary CT angiography: a pictorial essay and management proposal Pinto, Erique Penha, Diana Hochhegger, Bruno Monaghan, Colin Marchiori, Edson Taborda-Barata, Luís Irion, Klaus J Bras Pneumol Pictorial Essay 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. Sociedade Brasileira de Pneumologia e Tisiologia 2022-05-03 /pmc/articles/PMC9064655/ /pubmed/35584528 http://dx.doi.org/10.36416/1806-3756/e20220015 Text en © 2022 Sociedade Brasileira de Pneumologia e Tisiologia https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License
spellingShingle Pictorial Essay
Pinto, Erique
Penha, Diana
Hochhegger, Bruno
Monaghan, Colin
Marchiori, Edson
Taborda-Barata, Luís
Irion, Klaus
Incidental chest findings on coronary CT angiography: a pictorial essay and management proposal
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 Pictorial Essay
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9064655/
https://www.ncbi.nlm.nih.gov/pubmed/35584528
http://dx.doi.org/10.36416/1806-3756/e20220015
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