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

Detalhes bibliográficos
Autor(a) principal: Pinto,Erique
Data de Publicação: 2022
Outros Autores: Penha,Diana, Hochhegger,Bruno, Monaghan,Colin, Marchiori,Edson, Taborda-Barata,Luís, Irion,Klaus
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Jornal Brasileiro de Pneumologia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132022000400700
Resumo: 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.
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spelling Incidental chest findings on coronary CT angiography: a pictorial essay and management proposalIncidental findingsCardiac-gated imaging techniquesCoronary angiographyLung neoplasmsABSTRACT 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 Tisiologia2022-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132022000400700Jornal Brasileiro de Pneumologia v.48 n.4 2022reponame:Jornal Brasileiro de Pneumologia (Online)instname:Sociedade Brasileira de Pneumologia e Tisiologia (SBPT)instacron:SBPT10.36416/1806-3756/e20220015info:eu-repo/semantics/openAccessPinto,EriquePenha,DianaHochhegger,BrunoMonaghan,ColinMarchiori,EdsonTaborda-Barata,LuísIrion,Klauseng2022-05-10T00:00:00Zoai:scielo:S1806-37132022000400700Revistahttp://www.jornaldepneumologia.com.br/default.aspONGhttps://old.scielo.br/oai/scielo-oai.php||jbp@jbp.org.br|| jpneumo@jornaldepneumologia.com.br1806-37561806-3713opendoar:2022-05-10T00:00Jornal Brasileiro de Pneumologia (Online) - Sociedade Brasileira de Pneumologia e Tisiologia (SBPT)false
dc.title.none.fl_str_mv 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
spellingShingle Incidental chest findings on coronary CT angiography: a pictorial essay and management proposal
Pinto,Erique
Incidental findings
Cardiac-gated imaging techniques
Coronary angiography
Lung neoplasms
title_short 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_sort Incidental chest findings on coronary CT angiography: a pictorial essay and management proposal
author Pinto,Erique
author_facet Pinto,Erique
Penha,Diana
Hochhegger,Bruno
Monaghan,Colin
Marchiori,Edson
Taborda-Barata,Luís
Irion,Klaus
author_role author
author2 Penha,Diana
Hochhegger,Bruno
Monaghan,Colin
Marchiori,Edson
Taborda-Barata,Luís
Irion,Klaus
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Pinto,Erique
Penha,Diana
Hochhegger,Bruno
Monaghan,Colin
Marchiori,Edson
Taborda-Barata,Luís
Irion,Klaus
dc.subject.por.fl_str_mv Incidental findings
Cardiac-gated imaging techniques
Coronary angiography
Lung neoplasms
topic Incidental findings
Cardiac-gated imaging techniques
Coronary angiography
Lung neoplasms
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.
publishDate 2022
dc.date.none.fl_str_mv 2022-01-01
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Pneumologia e Tisiologia
publisher.none.fl_str_mv Sociedade Brasileira de Pneumologia e Tisiologia
dc.source.none.fl_str_mv Jornal Brasileiro de Pneumologia v.48 n.4 2022
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