Incidental chest findings on coronary CT angiography: a pictorial essay and management proposal
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , |
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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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 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132022000400700 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132022000400700 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.36416/1806-3756/e20220015 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
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 reponame:Jornal Brasileiro de Pneumologia (Online) instname:Sociedade Brasileira de Pneumologia e Tisiologia (SBPT) instacron:SBPT |
instname_str |
Sociedade Brasileira de Pneumologia e Tisiologia (SBPT) |
instacron_str |
SBPT |
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SBPT |
reponame_str |
Jornal Brasileiro de Pneumologia (Online) |
collection |
Jornal Brasileiro de Pneumologia (Online) |
repository.name.fl_str_mv |
Jornal Brasileiro de Pneumologia (Online) - Sociedade Brasileira de Pneumologia e Tisiologia (SBPT) |
repository.mail.fl_str_mv |
||jbp@jbp.org.br|| jpneumo@jornaldepneumologia.com.br |
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1750318348294422528 |