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Incidental extracardiac findings on cardiac MR: Systematic review and meta-analysis
Vincent Dunet1, Juerg Schwitter2,3, Reto Meuli1,2
1Department of Radiodiagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland.
Purpose:
To perform a systematic review and meta-analysis to calculate the pooled prevalence of incidental extracardiac findings (IEFs) on cardiac magnetic resonance (MR) and to determine factors influencing reported prevalences.
Materials And Methods:
We examined studies published in the literature using the MEDLINE database. Studies reporting IEFs on cardiac MR were included. Meta-analysis provided pooled prevalences of total, minor, major IEFs, and major IEFs with patient management changes using a random-effects model. Heterogeneity and inconsistency (I-squared) between studies as well as publication bias were assessed.
Results:
Twelve studies including 7062 patients (mean age: 52 years, range: 0.5-93 years, 4476 male/2586 female) and 7122 cardiac MR examinations were considered in the meta-analysis. Overall, the pooled prevalence of total IEFs was 35% (95% confidence interval [CI]: 23-47%). The pooled prevalence of minor and major IEFs were 17% (95% CI: 9-26%) and 12% (95% CI: 7-18%), respectively. Newly diagnosed major IEFs changed patient management in 1% (95% CI: 1-2%) of the study population. A high heterogeneity and inconsistency (I-squared >74%) between studies without publication bias were observed, notably due to IEFs recording method (P < 0.002) and formal training of cardiac MR readers (P < 0.006).
Conclusion:
Major IEFs may be found in 12% of patients undergoing cardiac MR examination and change the management in 1% of patients. Readers' training for the evaluation of noncardiac structures increases reported prevalence.
Insights
Incidental extracardiac findings (IEFs) are common on cardiac MRI, found in 35% of patients. Major IEFs, impacting management in 1%, are more frequently reported when readers have formal training.
Area of Science:
- Radiology
- Cardiovascular Imaging
- Medical Diagnostics
Background:
- Cardiac magnetic resonance (MR) imaging is a key tool for assessing cardiac structure and function.
- Incidental extracardiac findings (IEFs) are frequently observed during these examinations.
- Understanding the prevalence and impact of IEFs is crucial for comprehensive patient care.
Purpose of the Study:
- To systematically review and meta-analyze the pooled prevalence of IEFs detected via cardiac MR.
- To identify factors influencing the reported prevalence of IEFs in the literature.
Main Methods:
- A systematic literature search was conducted using the MEDLINE database.
- Studies reporting IEFs on cardiac MR examinations were included in the meta-analysis.
- Random-effects modeling was used to pool prevalences, assessing heterogeneity and publication bias.
Main Results:
- The meta-analysis included 12 studies with 7062 patients and 7122 cardiac MR examinations.
- The pooled prevalence of any IEF was 35%, with minor IEFs at 17% and major IEFs at 12%.
- Major IEFs led to changes in patient management in 1% of cases, with significant heterogeneity linked to IEF recording methods and reader training.
Conclusions:
- Approximately 12% of patients undergoing cardiac MR have major IEFs, with 1% experiencing management changes.
- Formal training for cardiac MR readers in evaluating noncardiac structures is associated with higher reported prevalence rates of IEFs.
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