Chest CT incidentalomas: thyroid lesions, enlarged mediastinal lymph nodes, and lung nodules

Frank, Luba; Quint, Leslie E.

doi:10.1102/1470-7330.2012.0006

Cited by 37 publications

(22 citation statements)

References 25 publications

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“…Bronchoscopy or CT-guided biopsy is often used to sample the tumor for histopathology [79].Lung cancer often appears as a solitary pulmonary nodule on a chest radiograph. Many other disease can also give this appearance, including metastatic cancer, hamartomas, and infectious granulomas such as tuberculosis, histoplasmosis and coccidioidomycosis [80].Lung cancer can also be an incidental finding as a solitary pulmonary nodule on a chest radiograph or CT scan done for an unrelated reason [81].…”

Section: Diagnosismentioning

confidence: 99%

Lung Cancer: Risk Factors, Management, And Prognosis

Mustafa¹,

Azizi²,

IIIzam³

et al. 2016

IOSR

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Section: Diagnosismentioning

confidence: 99%

Lung Cancer: Risk Factors, Management, And Prognosis

Mustafa¹,

Azizi²,

IIIzam³

et al. 2016

IOSR

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“…An incidental finding can be defined as an unsuspected finding that is not related to the clinical reason for performing the diagnostic test (8,9). Examples of incidental findings that can be identified on attenuation-correction CT images of the chest include coronary vessel calcification, vascular anomalies, valve replacement, pacemakers, atelectasis, effusion, consolidation, lobar collapse, nodules, masses, pulmonary metastases, ground glass opacities, and aortic aneurysm (20).…”

Section: Definitions and Frequency Of Incidental Findingsmentioning

confidence: 99%

“…Previously unknown incidental findings are termed new incidental findings and are likely to fall into 1 of 3 categories: clinically significant, clinically insignificant, or indeterminate. Clinically significant incidental findings are highly suspected of having an underlying pathology that may negatively affect patient wellbeing, requiring further investigation (9).…”

Section: Definitions and Frequency Of Incidental Findingsmentioning

confidence: 99%

“…However, identifying incidental findings may increase risk to the patient without necessarily providing any benefit. Further diagnostic examinations are often associated with an increase in ionizing radiation dose and possibly invasive procedures that may carry physical risk and cause psychologic harm to the patient (9,18,19). Furthermore, only a small percentage of these incidental findings are significant at definitive diagnosis (9,20,21).…”

Section: Incidental Findings On Spect/ct Mpimentioning

confidence: 99%

See 1 more Smart Citation

The Clinical Dilemma of Incidental Findings on the Low-Resolution CT Images from SPECT/CT MPI Studies

Coward

Nightingale

Hogg

2016

J. Nucl. Med. Technol.

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CE credit: For CE credit, you can access the test for this article, as well as additional JNMT CE tests, online at https://www.snmmilearningcenter.org. Complete the test online no later than September 2019. Your online test will be scored immediately. You may make 3 attempts to pass the test and must answer 80% of the questions correctly to receive 1.0 CEH (Continuing Education Hour) credit. SNMMI members will have their CEH credit added to their VOICE transcript automatically; nonmembers will be able to print out a CE certificate upon successfully completing the test. The online test is free to SNMMI members; nonmembers must pay $15.00 by credit card when logging onto the website to take the test.Incidental findings are common in medical imaging. There is a particularly high prevalence of incidental findings within the thorax, the most frequent being pulmonary nodules. Although pulmonary nodules have the potential to be malignant, most are benign, resulting in a high number of false-positive findings. Low-resolution CT images produced for attenuation correction of SPECT images are essentially a by-product of the imaging process. The high number of false-positive incidental findings detected on these attenuation-correction images causes a reporting dilemma. Early detection of cancer can be beneficial, but falsepositive findings and overdiagnosis can be detrimental to the patient. Attenuation-correction CT images are not of diagnostic quality, and further diagnostic tests are usually necessary for a definitive diagnosis to be reached. Given the high number of falsepositive findings, the psychologic effect on the patient should be considered. This review recommends caution when the findings on attenuation-correction CT images are routinely reported. Medi cal imaging uses a range of modalities that yield both anatomic and functional information (1). Visual correlation of images acquired using separate modalities can provide more information than images from a single modality alone, though there is an inevitable risk of misregistration between images that have been acquired during different imaging sessions. The development of hybrid imaging has led to the integration of two modalities in one machine, allowing coregistration of images that have been acquired in a single session (1,2). This allows direct correlation of anatomic and functional information, increasing sensitivity and specificity while adding clarity to indeterminate cases (3). SPECT/CT offers an excellent example of hybrid imaging, combining the functional ability of SPECT with the anatomic ability of CT.The strength of SPECT lies in gaining pathophysiologic detail in a minimally invasive way (4). Pathologic processes can be identified by uptake of radiopharmaceuticals, but the precise location is often difficult to ascertain because of low image resolution and a lack of anatomic landmarks. Moreover, uptake on some scans is often nonspecific, revealing abnormalities but not their specific cause. CT can provide a useful means of localization, also enabl...

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“…how to handle incidental findings (incidentalomas) that are increasingly identified in children as a result of a higher reliance on advanced cross-sectional imaging studies [1][2][3][4]. This issue, as it pertains to the adult population, has received attention in the lay news media [5][6][7] and in a recent bioethical directive by the Obama administration [8] and is only recently being formally recognized by the profession and addressed in review articles [3,9].…”

Section: Introductionmentioning

confidence: 99%

The incidental pulmonary nodule in a child

et al. 2015

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The incidental detection of small lung nodules in children is a vexing consequence of an increased reliance on CT. We present an algorithm for the management of lung nodules detected on CT in children, based on the presence or absence of symptoms, the presence or absence of elements in the clinical history that might explain these nodules, and the imaging characteristics of the nodules (such as attenuation measurements within the nodule). We provide suggestions on how to perform a thoughtfully directed and focused search for clinically occult extrathoracic disease processes (including malignant disease) that may present as an incidentally detected lung nodule on CT. This algorithm emphasizes that because of the lack of definitive information on the natural history of small solid nodules that are truly detected incidentally, their clinical management is highly dependent on the caregivers' individual risk tolerance. In addition, we present strategies to reduce the prevalence of these incidental findings, by preventing unnecessary chest CT scans or inadvertent inclusion of portions of the lungs in scans of adjacent body parts. Application of these guidelines provides pediatric radiologists with an important opportunity to practice patient-centered and evidence-based medicine.

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Chest CT incidentalomas: thyroid lesions, enlarged mediastinal lymph nodes, and lung nodules

Cited by 37 publications

References 25 publications

Lung Cancer: Risk Factors, Management, And Prognosis

Lung Cancer: Risk Factors, Management, And Prognosis

The Clinical Dilemma of Incidental Findings on the Low-Resolution CT Images from SPECT/CT MPI Studies

The incidental pulmonary nodule in a child

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