Dealing with Incidental Findings

“Incidental findings abound in cardiac CT imaging…with some 37 percent of studies having incidental findings,” confirmed Jerry Breen, MD, chair, Division of Cardiac Radiology at the Mayo Clinic in Rochester, Minn., at the July annual meeting of the Society of Cardiovascular CT (SCCT).
   
Issues stem from stomach problems that reveal bowel disease or lung cancer. Chest pain can mean rib fractures or stomach issues. And post liver transplant imaging can show a problem in the hepatic artery or a liver abscess.

“If it’s on the film, it’s on the film forever,” said Breen who urged radiologists and cardiologists to use caution and diligence in fully reading each scan.
   
What’s key is negotiating exclusive applications, hiring good technologists, appropriate patient selection and workstation review, standardization of image review, thinking and double-thinking of imaging protocols and having appropriate equipment in the first place. He urged the review of source images on appropriate workstations, noting that 3D images are cool, pretty and striking but source images should be used for diagnosis. “You can't buy yourself a better exam,” he said, noting that thinner slices are better than thicker and faster is best since fewer artifacts results from quick scanning.