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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Clinical Imaging of Microwave Mammography
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Imaging-based screening: maximizing benefits and minimizing harms.

Jessica C Germino1, Joann G Elmore2, Ruth C Carlos3

  • 1Department of Radiology, University of Washington School of Medicine, 825 Eastlake Avenue East, G3-200, Seattle, WA, 98109-1023.

Clinical Imaging
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Summary

Advanced imaging screening offers benefits but carries risks like false positives and radiation exposure. Radiologists should focus on interpretation, thresholds, and personalized screening to improve patient outcomes.

Keywords:
False-positivesImaging-based screeningIncidental findingsOverdiagnosisScreening harms

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Area of Science:

  • Medical Imaging
  • Radiology
  • Public Health

Background:

  • Advanced imaging is crucial for screening asymptomatic individuals.
  • The benefits versus risks of imaging screening are not always clear.
  • Concerns include false positives, incidental findings, overdiagnosis, and radiation risks.

Purpose of the Study:

  • To review controversies in imaging-based screening.
  • To suggest areas for radiologists to improve screening benefits.
  • To reduce harms associated with imaging screening.

Main Methods:

  • Literature review of imaging screening controversies.
  • Analysis of factors influencing screening outcomes.
  • Discussion of strategies to optimize screening protocols.

Main Results:

  • Imaging screening presents a complex benefit-risk balance.
  • Key areas for improvement include interpretive variability and abnormal finding thresholds.
  • Personalized, risk-based screening approaches are recommended.

Conclusions:

  • Radiologists must address screening controversies to maximize patient benefit.
  • Focusing on interpretive consistency and risk stratification can mitigate harms.
  • Personalized screening strategies are essential for responsible use of advanced imaging.