Collateral non cardiac findings in clinical routine CT coronary angiography: results from a multi-center registry

Area of Science:

• Radiology and Imaging
• Cardiovascular Imaging
• Oncology

Background:

• Computed tomography coronary angiography (CTCA) is primarily used to diagnose coronary artery disease (CAD).
• Incidental findings during CTCA are common but their prevalence and clinical significance require further evaluation.
• A multi-center registry provides a robust dataset for assessing these findings.

Purpose of the Study:

• To determine the prevalence of collateral findings identified during CTCA in a multi-center registry.
• To categorize the significance of these incidental findings (non-significant, significant, major).
• To assess the clinical relevance of these findings in relation to existing CAD.

Main Methods:

• Retrospective review of 4303 patients undergoing 64-slice CTCA for suspected or known CAD.
• Data collected from multiple academic institutions between January 2006 and September 2010.
• Collateral findings were systematically recorded and classified based on predefined criteria.

Main Results:

• A total of 6886 non-cardiac findings were detected, averaging 1.6 per patient.
• Only 20.1% of patients had no additional findings.
• Significant (65.2%) and major (4.4%) findings were prevalent, including primary lung cancer (21 cases) and mediastinal lymphadenopathy.

Conclusions:

• The prevalence of significant and major collateral findings in CTCA is substantial.
• Incidental findings can be clinically more relevant than the underlying CAD.
• Thorough review of the entire CTCA scan volume by radiologists is crucial for patient care.