Concurrent Chest and Abdominal CT: Managing Pitfalls of Splitting Interpretation by Subspecialty

Radiology practices may choose to divide interpretation of concurrently acquired chest and abdominal CT examinations between two readers. Although this approach has benefits, there also are potential pitfalls that should be recognized and avoided, such as differences in contrast material timing that can cause an abdominal finding to be more conspicuous on the chest examination, and vice versa. Pathologic lesions that cross the boundary between the chest and abdomen, as well as precise delineation of that boundary, also create issues. Additionally, there can be uncertainty regarding the responsibilities as a secondary reader for the region of overlap. Example cases demonstrate these potential pitfalls, and strategies are provided for mitigating or avoiding them. These cases include pancreatic adenocarcinoma visualized only on the chest images, pulmonary embolism best seen on the abdominal images, and metastatic gastrointestinal stromal tumor invading into the chest. Mitigation strategies discussed include appropriate search pattern modification as well as the importance of establishing guidelines and facilitating ease of communication between radiologists. ^©RSNA, 2025.