Patient-centered clinical impact of incidentally detected abnormalities on chest CT scans

Abstract

Purpose: To demonstrate the spectrum of incidental findings on chest CT scans and to evaluate the clinical impact of significant different abnormalities on patient management. Materials and methods: This retrospective study included incidental findings on chest CT scans from an adult patient population, performed at the University of Washington, within a 10 month period. After exclusion of repetitive findings, 113 patients (50 males and 63 females, age 18–96 years, mean = 57.3 years) demonstrated 163 uniquely different findings. We determined the clinical significance according to the need for further workup and/or therapy. The gold standard for diagnosis was either by pathologic proof, follow up CT, or other imaging modalities. Results: 38 different findings were judged clinically significant (10.4%) requiring further workup and/or therapy in 9.6% and 7.1%, respectively. The anatomic site of disease was: intra-thoracic (n = 27, 71.1%), extra-thoracic (n = 5, 13.1%), lower neck (n = 3, 7.9%), and upper abdomen (n = 3, 7.9%). They included 12 unique malignant pathologies (31.6%), and 26 non-malignant findings (68.4%). Conclusion: The clinically significant different incidental abnormalities on chest CT scans represented 10.4% of all incidental findings, 3.3% were due to malignancies. The clinical impact of incidental abnormalities on chest CT may be of utmost importance on patient care.

Keywords

• Spectrum of incidental findings
• Clinical impact of incidental findings on patient management
• Incidental malignant findings