Incidental findings on cervical spine computed tomography scans: overlooked and unimportant?

Beheshtian, Elham; Sahraian, Sadaf; Yousem, David M.; Khan, Majid

doi:10.1007/s00234-018-2080-7

Cited by 7 publications

(7 citation statements)

References 17 publications

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“…The field of view in the oral and maxillofacial region often includes a region from the base of the brain to the apex of the lung, and thus oral radiologists need to take care to observe adjacent regions in the images. Indeed, many incidental findings have been described in previous reports (6)(7)(8)(9)(19)(20)(21). The thyroid gland should be focused upon because its entirety is frequently included in CT images of the oral and maxillofacial region.…”

Section: Discussionmentioning

confidence: 97%

“…With the development of imaging modalities in recent years, there has been an increase in the identification of incidental lesions on images obtained by CT and MRI, as advanced imaging modalities (6)(7)(8)(9)(19)(20)(21). In particular, CT machines are maintained at many facilities, and it is possible to obtain more detailed diagnoses by CT immediately after lesions are suspected on plain radiographs of the oral and maxillofacial region.…”

Section: Discussionmentioning

confidence: 99%

“…The numbers of abnormal findings incidentally detected in adjacent regions are increasing with advances in imaging modalities (6)(7)(8)(9). Such findings are often observed on CT images with extended fields of view.…”

Section: Introductionmentioning

confidence: 99%

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Incidental findings in the thyroid gland on computed tomography images of the oral and maxillofacial region

et al. 2020

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The numbers of abnormal findings incidentally detected in adjacent regions are increasing with advances in imaging modalities. The present study aimed to examine the prevalence and characteristics of incidental findings in the thyroid gland on computed tomography (CT) images of the oral and maxillofacial region. CT scans of the oral and maxillofacial region in patients obtained between January 2012 and December 2016 were retrospectively reviewed. Images that revealed incidental findings in the thyroid gland, including nodules, were recorded, together with the sizes and characteristics of the findings. The Japan Association of Breast and Thyroid Sonology (JABTS) guidelines were used for classification. The rate of descriptions of these findings in the radiographic interpretation reports were also examined. Of the 1,135 patients examined, 326 (28.7%) had several types of incidental findings. In particular, 169 (14.9%) of the 1,135 patients had nodules >5 mm in diameter, for which further careful examination is recommended in the JABTS guideline. The description rate for nodules >5 mm in diameter in the radiographic interpretation reports was 30.8% (52/169 patients), of whom 17.3% (9/52 patients) were referred to the endocrinology department for further careful examination. Incidental findings in the thyroid gland were relatively common on CT images of the oral and maxillofacial region. Oral radiologists tend to focus specifically on the oral and maxillofacial region during diagnosis on oral and maxillofacial CT images, but should pay the same careful attention to observe adjacent regions, such as the thyroid gland.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Incidental findings in the thyroid gland on computed tomography images of the oral and maxillofacial region

et al. 2020

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“…We also found discrepancies between re-interpretation and original radiology reports, in which both under- and overreads exist. Beheshtian et al [ 13 ] found that only 20 out of 701 incidentalomas (2.9%) were documented in 2116 original cervical spine CT reports. In contrast, Barboza et al [ 4 ] identified a 9.1% missed rate in 1256 official trauma cervical spine CT reports, in which the majority (75%) of incidentalomas were nontraumatic findings.…”

Section: Discussionmentioning

confidence: 99%

“…This examination typically covers the skull base to T1 or T2 vertebrae, and is therefore inclusive of many structures within the thoracic inlet, such as bones, pleurae and lung apices [ 1 , 10 , 11 ]. A few previous investigations have reported a high prevalence of incidental CT findings on trauma cervical spine CT [ 4 , 12 , 13 ]. Based on our experience, a careful review of thoracic inlet images included in a cervical spine CT of trauma patients can reveal potentially important findings not shown on a concurrent pCXR.…”

Section: Introductionmentioning

confidence: 99%

Thoracic Inlet in Cervical Spine CT of Blunt Trauma Patients: Prevalence of Pathologies and Importance of CT Interpretation

et al. 2022

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Background: The thoracic inlet of blunt trauma patients may have pathologies that can be diagnosed on cervical spine computed tomography (CT) but that are not evident on concurrent portable chest radiography (pCXR). This retrospective investigation aimed to identify the prevalence of thoracic inlet pathologies on cervical spine CT and their importance by measuring the diagnostic performance of pCXR and the predictive factors of such abnormalities. Methods: This investigation was performed at a level-1 trauma center and included CT and concurrent pCXR of 385 consecutive adult patients (280 men, mean age of 47.6 years) who presented with suspected cervical spine injury. CT and pCXR findings were independently re-reviewed, and CT was considered the reference standard. Results: Traumatic, significant nontraumatic and nonsignificant pathologies were present at 23.4%, 23.6% and 58.2%, respectively. The most common traumatic diagnoses were pneumothorax (12.7%) and pulmonary contusion (10.4%). The most common significant nontraumatic findings were pulmonary nodules (8.1%), micronodules (6.8%) and septal thickening (4.2%). The prevalence of active tuberculosis was 3.4%. The sensitivity and positive predictive value of pCXR was 56.67% and 49.51% in diagnosing traumatic and 8.89% and 50% in significant nontraumatic pathologies. No demographic or pre-admission clinical factors could predict these abnormalities. Conclusions: Several significant pathologies of the thoracic inlet were visualized on trauma cervical spine CT. Since a concurrent pCXR was not sensitive and no demographic or clinical factors could predict these abnormalities, a liberal use of chest CT is suggested, particularly among those experiencing high-energy trauma with significant injuries of the thoracic inlet. If chest CT is not available, a meticulous evaluation of the thoracic inlet in the cervical spine CT of blunt trauma patients is important.

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Automatic detection of cervical lymph nodes in patients with oral squamous cell carcinoma using a deep learning technique: a preliminary study

et al. 2020

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Incidental findings on cervical spine computed tomography scans: overlooked and unimportant?

Abstract: Cervical incidentalomas vary in rates from ARSA (0.86%) to LC (9.4%). They are rarely mentioned in radiologists' reports. Whether improved vigilance and reporting of these incidentalomas would benefit patient care should be explored.

Cited by 7 publications

References 17 publications

Incidental findings in the thyroid gland on computed tomography images of the oral and maxillofacial region

Incidental findings in the thyroid gland on computed tomography images of the oral and maxillofacial region

Thoracic Inlet in Cervical Spine CT of Blunt Trauma Patients: Prevalence of Pathologies and Importance of CT Interpretation

Automatic detection of cervical lymph nodes in patients with oral squamous cell carcinoma using a deep learning technique: a preliminary study

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