Non-cardiac findings on coronary electron beam computed tomography scanning

The objective of this study was to estimate the prevalence and significance of non-cardiac findings on Electron Beam Computed Tomography (EBT) scanning when used in population screening for the quantitative measurement of coronary artery calcium and estimate of coronary risk. Clinic files of 1366 subjects who underwent EBT scanning between September 1996 and December 1998 at the University of Pittsburgh affiliated Comprehensive Heart Care Center were abstracted. The files of 1356 subjects contained the calcium score and non-cardiac findings as reported by board-certified radiologists, who interpreted the scans during the period 1996-1998. A National Death Index (NDI) Plus match was performed to ascertain cause of death. Two hundred seventy-eight of 1356 (20.5%) subjects had 1 or more non-cardiac findings on EBT scanning. Fifty-seven of 1356 (4.2%) received a recommendation for diagnostic CT follow-up. Forty-six of the 57 recommendations were for pulmonary nodules and 11 were for non-nodule, non-cardiac findings. Seven members of the cohort died during a short follow-up period. In 1 case, the non-cardiac finding was the cause of death. Non-cardiac findings in a healthy cohort referred for EBT coronary screening are relatively common. Findings range from clinically insignificant to the cause of death during a short follow-up period. EBT scanning is a frequently used coronary screening procedure. With the relatively high detection of significant, non-cardiac pathology in this increasingly common screening procedure, consideration should be given for radiologists to interpret the scans.