The prevalence of extracardiac findings by multidetector computed tomography before atrial fibrillation ablation

Schietinger, Brian J.; Bozlar, Uğur; Hagspiel, Klaus D.; Norton, Patrick T.; Greenbaum, Heather R.; Wang, Hongkun; Isbell, David C.; Patel, Rajan A.G.; Ferguson, John; Kramer, Christopher M.; Mangrum, J. Michael

doi:10.1016/j.ahj.2007.10.008

Cited by 29 publications

(35 citation statements)

References 19 publications

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“…In 179 of the 224 patients (80 %), one or more incidental extra-cardiac findings were noted per patient. This is consistent with the literature in which the percentage of extra-cardiac findings at cardiac CT ranges from 8 % in asymptomatic patients [10] to 69 % in symptomatic patients [12] with known or suspected CAD. In our study we observed a relatively high incidence of extra-cardiac and cardiac findings, which may be due to the detailed image and the advanced mean age of our patients.…”

Section: Relevance Of the Study Findings With Comparison To The Litersupporting

confidence: 81%

“…There was also a high incidence of unclear benefit, limited follow-up period and different imaging methods applied [23]. [12,15,26]. These values are in the range of former CT studies for CAD detection as described before [10,11].…”

Section: Relevance Of the Study Findings With Comparison To The Litermentioning

confidence: 99%

“…According to other authors, the incidence of extra-cardiac findings at cardiac CT ranged from 8 % in asymptomatic patients [10] to 58 % in symptomatic patients with known or suspected coronary artery disease (CAD), and up to 22 % if the patients had clinically significant findings that required at least a follow-up [11]. Schietinger et al reported extra-cardiac incidental findings even in 69 % of patients who were scanned prior to pulmonary vein isolation [12]. Most previous studies about cardiac CT concentrated on either cardiac findings or incidental extra-cardiac findings and did not evaluate the cost of subsequent diagnostics [10,11,13,14].…”

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confidence: 99%

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Current Role of Cardiac and Extra-Cardiac Pathologies in Clinically Indicated Cardiac Computed Tomography with Emphasis on Status Before Pulmonary Vein Isolation

Sohns

Menke

Staab

et al. 2014

Fortschr Röntgenstr

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Purpose: The aim of this study was to assess the incidence of cardiac and significant extra-cardiac findings in clinical computed tomography of the heart in patients with atrial fibrillation before pulmonary vein isolation (PVI). Materials and Methods: 224 patients (64???10 years; male 63?%) with atrial fibrillation were examined by cardiac 64-slice multidetector CT before PVI. Extra-cardiac findings were classified as ?significant? if they were recommended to additional diagnostics or therapy, and otherwise as ?non-significant?. Additionally, cardiac findings were documented in detail. Results: A total of 724 cardiac findings were identified in 203 patients (91?% of patients). Additionally, a total of 619 extra-cardiac findings were?identified in 179 patients (80?% of patients). Among these extra-cardiac findings 196 (32?%) were ?significant?, and 423 (68?%) were ?non-significant?. In 2 patients (1?%) a previously unknown malignancy was detected (esophageal cancer and lung cancer, local stage, no metastasis). 203 additional imaging diagnostics followed to clarify the ?significant? findings (124 additional CT, costs 38?314.69 US dollars). Overall, there were 3.2 cardiac and 2.8 extra-cardiac findings per patient. Extra-cardiac findings appear significantly more frequently in patients over 60 years old, in smokers and in patients with a history of cardiac findings (p?<0.05). Conclusion: Cardiac CT scans before PVI should be screened for extracardiac incidental findings that could have important clinical implications for each patient. Key points: ??Cardiac and extra-cardiac findings are common in patients with an indication for pulmonary vein isolation on previous CT scans. ??Malignancies can be detected in 1?% of all patients. ??32?% of all extra-cardiac findings can be of significant relevance with consequences for patients. ??Altogether, there are 3.2 cardiac and 2.8 extra-cardiac findings in patients with indication for pulmonary vein isolation and CT. ??Extra-cardiac findings appear significantly more frequently in patients over 60 years old, in smokers and in patients with a history of cardiac findings (p?<0.05). Citation Format: ??Sohns JM, Menke J, Staab W et?al. Current Role of Cardiac and Extra-Cardiac Pathologies in Clinically Indicated Cardiac Computed Tomography with Emphasis on Status Before Pulmonary Vein Isolation. Fortschr R?ntgenstr 2014; 186: 860???867

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Section: Relevance Of the Study Findings With Comparison To The Litersupporting

confidence: 81%

Section: Relevance Of the Study Findings With Comparison To The Litermentioning

confidence: 99%

mentioning

confidence: 99%

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Current Role of Cardiac and Extra-Cardiac Pathologies in Clinically Indicated Cardiac Computed Tomography with Emphasis on Status Before Pulmonary Vein Isolation

Sohns

Menke

Staab

et al. 2014

Fortschr Röntgenstr

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“…The impact of hybrid SPECT/CTon the performance of functional imaging, such as 75 Se-selenomethylnorcholesterol or 131 I-iodocholesterol imaging, remains to be determined, because only scant data can be found in the literature.…”

Section: Spect/ct In Tumors Of Sympathetic Nervous System and Adrenocmentioning

confidence: 99%

“…In a pilot study, Even-Sapir et al reported a change in clinical management for a few patients undergoing 75 Se-cholesterol SPECT/CT (53). Despite an obvious lack of clinical studies demonstrating the superiority of SPECT/CT over separately performed imaging modalities, it can be speculated that hybrid imaging will increase diagnostic accuracy and may lead to the more frequent use of functional imaging techniques.…”

Section: Spect/ct In Tumors Of Sympathetic Nervous System and Adrenocmentioning

confidence: 99%

Spect/Ct

Buck¹,

Nekolla²,

Ziegler³

et al. 2008

J Nucl Med

272

149

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In view of the commercial success of integrated PET/CT scanners, there is an increasing interest in comparable SPECT/CT systems. SPECT in combination with CT enables a direct correlation of anatomic information and functional information, resulting in better localization and definition of scintigraphic findings. Besides anatomic referencing, the added value of CT coregistration is based on the attenuation correction capabilities of CT. The number of clinical studies is limited, but pilot studies have indicated a higher specificity and a significant reduction in indeterminate findings. The superiority of SPECT/CT over planar imaging or SPECT has been demonstrated in bone scintigraphy, somatostatin receptor scintigraphy, parathyroid scintigraphy, and adrenal gland scintigraphy. Also, rates of detection of sentinel nodes by biopsy can be increased with SPECT/CT. This review highlights recent technical developments in integrated SPECT/CT systems and summarizes the current literature on potential clinical uses and future directions for SPECT/CT in cardiac, neurologic, and oncologic applications.

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