Nicola Sverzellati1, Teresa Arcadi2, Luca Salvolini3, Roberto Dore4, Maurizio Zompatori5, Manuela Mereu6, Giuseppe Battista7, Ilenia Martella8, Francesco Toni7, Luciano Cardinale9, Erica Maffei10, Fabio Maggi11, Filippo Cademartiri10, Tommaso Pirronti11. 1. Section of Diagnostic Imaging, Department of Surgical Sciences, University of Parma, Padiglione Barbieri, University Hospital of Parma, V. Gramsci 14, 43100, Parma, Italy. nicolasve@tiscali.it. 2. Department of Radiology, SDN Foundation, IRCCS, Naples, Italy. 3. Radiologia Clinica, Di.S.C.O., Università Politecnica delle Marche, Ancona, Italy. 4. UOS Radiologia Toracica e TC, Istituto di Radiologia Fondazione Policlinicio San Matteo IRCCS, Pavia, Italy. 5. Radiology Unit, Cardio-Thoracic-Vascular Department, University Hospital S. Orsola-Malpighi, Bologna, Italy. 6. Section of Integrated Imaging and Radiological Therapies, Department of Neuroscience, University of Chieti, Chieti, Italy. 7. Division of Radiology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. 8. Section of Diagnostic Imaging, Department of Surgical Sciences, University of Parma, Padiglione Barbieri, University Hospital of Parma, V. Gramsci 14, 43100, Parma, Italy. 9. Institute of Radiology, University of Turin, AOU San Luigi Gonzaga, Orbassano, Turin, Italy. 10. Department of Radiology, Erasmus Medical Center University, Rotterdam, 3015, Rotterdam, The Netherlands. 11. Department of Bioimaging and Radiological Sciences, Catholic University of Rome, Rome, Italy.
Abstract
PURPOSE: It is unclear whether (and, to what extent) radiologists look at and report cardiovascular abnormalities on non-cardio-synchronized standard chest computed tomography (CT). In this study, the frequency and the reporting rate of cardiovascular findings in chest CT examinations were retrospectively assessed. MATERIALS AND METHODS: This study was approved by the institutional review board of each participating center. Four academic centers provided data on 447 subjects who underwent non-ECG-synchronized chest CT examinations for evaluating pulmonary fibrosis (161/447, 36 %), suspected pulmonary embolism (140/447, 31.3 %), or lung cancer staging (146/447, 32.7 %). A total of 220/447 (53.7 %) and 227/447 CT (46.3 %) examinations were evaluated and reported by junior and senior chest radiologists, respectively. Two radiologists with training in cardiac imaging reviewed the same chest CT images looking for the presence of incidental cardiovascular abnormalities using a preformatted score sheet. Inter-observer agreement was assessed using the kappa coefficient of agreement (k). RESULTS: Inter-observer agreement between the study reviewers was moderate to good (0.4-0.73) for most of the incidental cardiovascular findings. At least one incidental cardiovascular finding not documented in the original report was identified by the study reviewers in 225/409 (55 %) of chest CT examinations. A total of 168/266 (63.2 %) potentially clinically significant cardiovascular findings were unreported in the original reports of 177/447 (39.6 %) subjects (p < 0.0001). Senior radiologists tended to more frequently report coronary artery calcification (p = 0.0006), cardiac valves calcification (p = 0.0003), and ascending aorta enlargement (p = 0.01) compared to junior radiologists. CONCLUSIONS: Several cardiovascular abnormalities can be reliably identified on standard chest CT. Yet, they are often under-reported, even when they might be relevant to the patient's work-up.
PURPOSE: It is unclear whether (and, to what extent) radiologists look at and report cardiovascular abnormalities on non-cardio-synchronized standard chest computed tomography (CT). In this study, the frequency and the reporting rate of cardiovascular findings in chest CT examinations were retrospectively assessed. MATERIALS AND METHODS: This study was approved by the institutional review board of each participating center. Four academic centers provided data on 447 subjects who underwent non-ECG-synchronized chest CT examinations for evaluating pulmonary fibrosis (161/447, 36 %), suspected pulmonary embolism (140/447, 31.3 %), or lung cancer staging (146/447, 32.7 %). A total of 220/447 (53.7 %) and 227/447 CT (46.3 %) examinations were evaluated and reported by junior and senior chest radiologists, respectively. Two radiologists with training in cardiac imaging reviewed the same chest CT images looking for the presence of incidental cardiovascular abnormalities using a preformatted score sheet. Inter-observer agreement was assessed using the kappa coefficient of agreement (k). RESULTS: Inter-observer agreement between the study reviewers was moderate to good (0.4-0.73) for most of the incidental cardiovascular findings. At least one incidental cardiovascular finding not documented in the original report was identified by the study reviewers in 225/409 (55 %) of chest CT examinations. A total of 168/266 (63.2 %) potentially clinically significant cardiovascular findings were unreported in the original reports of 177/447 (39.6 %) subjects (p < 0.0001). Senior radiologists tended to more frequently report coronary artery calcification (p = 0.0006), cardiac valves calcification (p = 0.0003), and ascending aorta enlargement (p = 0.01) compared to junior radiologists. CONCLUSIONS: Several cardiovascular abnormalities can be reliably identified on standard chest CT. Yet, they are often under-reported, even when they might be relevant to the patient's work-up.
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