OBJECTIVES: (1) To establish the prevalence of incidental extra-cardiac findings (ECFs) in coronary multi detector computed tomography (CCT) performed in a large, homogeneous cohort of patients suspected of coronary artery disease (CAD). (2) To examine whether any association can be established between ECFs and pretest risk as determined by conventional risk factors for CAD, the Diamond-Forrester risk model or coronary artery calcium scores. (3) To assess cost related to extra-cardiac examinations. DESIGN: Retrospective study of consecutive patients who had CCT performed. A large field of view was recreated from the non-enhanced CT scan and evaluated by a radiologist for incidental ECFs. SUBJECTS: Patients with chest pain referred to CTA by a cardiologist. RESULTS: In 1383 patients a total of 481 ECFs were indentified, 378 minor (meaning no follow-up was needed) and 103 major ECFs (ECF followed up clinically and/or with additional imaging), in a total of 393 (28%) patients. 85 (6%) patients had one major ECF and 9 (0.7%) patients had two major ECFs. In 19 (4 cases of malignancy) patients the major ECF had therapeutic consequences. Significant positive associations were found between age and smoking, respectively and the presence of ECFs. The cost estimate of saving one life from malignant disease based on ECF examinations is 40,190€. CONCLUSION: Incidental extra-cardiac findings are common, sometimes revealing serious, even malignant disease. Diagnostic follow-up of major ECFs seems to be cost-effective in a Danish clinical setting. We recommend investigating a large field of view for incidental ECFs following CCT.
OBJECTIVES: (1) To establish the prevalence of incidental extra-cardiac findings (ECFs) in coronary multi detector computed tomography (CCT) performed in a large, homogeneous cohort of patients suspected of coronary artery disease (CAD). (2) To examine whether any association can be established between ECFs and pretest risk as determined by conventional risk factors for CAD, the Diamond-Forrester risk model or coronary artery calcium scores. (3) To assess cost related to extra-cardiac examinations. DESIGN: Retrospective study of consecutive patients who had CCT performed. A large field of view was recreated from the non-enhanced CT scan and evaluated by a radiologist for incidental ECFs. SUBJECTS:Patients with chest pain referred to CTA by a cardiologist. RESULTS: In 1383 patients a total of 481 ECFs were indentified, 378 minor (meaning no follow-up was needed) and 103 major ECFs (ECF followed up clinically and/or with additional imaging), in a total of 393 (28%) patients. 85 (6%) patients had one major ECF and 9 (0.7%) patients had two major ECFs. In 19 (4 cases of malignancy) patients the major ECF had therapeutic consequences. Significant positive associations were found between age and smoking, respectively and the presence of ECFs. The cost estimate of saving one life from malignant disease based on ECF examinations is 40,190€. CONCLUSION: Incidental extra-cardiac findings are common, sometimes revealing serious, even malignant disease. Diagnostic follow-up of major ECFs seems to be cost-effective in a Danish clinical setting. We recommend investigating a large field of view for incidental ECFs following CCT.
Authors: Alexandra Preuß; Lars-Arne Schaafs; Thomas Werncke; Ingo G Steffen; Bernd Hamm; Thomas Elgeti Journal: PLoS One Date: 2016-04-07 Impact factor: 3.240
Authors: Michelle C Williams; Amanda Hunter; Anoop S V Shah; John Dreisbach; Jonathan R Weir McCall; Mark T Macmillan; Rachael Kirkbride; Fiona Hawke; Andrew Baird; Saeed Mirsadraee; Edwin J R van Beek; David E Newby; Giles Roditi Journal: Eur Radiol Date: 2018-01-02 Impact factor: 5.315
Authors: Rasmus Bo Hasselbalch; Mia Pries-Heje; Thomas Engstrøm; Andreas Sandø; Merete Heitmann; Frants Pedersen; Morten Schou; Hans Mickley; Hanne Elming; Rolf Steffensen; Lars Koeber; Kasper Karmark Iversen Journal: Open Heart Date: 2019-10-03