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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Pneumologia e Tisiologia
2022
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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. |
format | Online Article Text |
id | pubmed-9064655 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Sociedade Brasileira de Pneumologia e Tisiologia |
record_format | MEDLINE/PubMed |
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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