A review of the issues surrounding incidental findings on
CT attenuation correction (CTAC ) images during SPECT
myocardial perfusion imaging

Coward, J

Abstract

Incidental findings are not uncommon on medical imaging with a particularly high prevalence identified in the chest. Pulmonary nodules contribute to a large proportion of incidental findings within the chest and these can often hinder definitive diagnosis because of their indeterminate nature. This is especially true of the incidental findings demonstrated on low-resolution CT images produced during CT attenuation correction (AC), as utilised in single-photon emission tomography (SPECT). The CTAC ‘images’ are effectively a by-product that were not intended for use in diagnosis.

Although there is the potential for pulmonary nodules to become malignant, the majority will be benign. This gives rise to a high number of false-positive findings for CT imaging of the chest. The high number of false-positive findings identified on CTAC images raises an issue of whether these images should be reviewed. Whilst early detection of cancer could lead to earlier intervention and possibly improve prognosis, the high number of false-positive findings on CTAC images increases risks to the patient and does not necessarily raise the benefits. The non-diagnostic quality of CTAC images usually necessitates further diagnostic tests and possibly intervention before a definitive diagnosis can be reached.

A balanced decision needs to be made on whether to interpret CTAC chest images, given the high number of false-positive findings, the potential psychological effects and harms to the patient. The recommendation of this review is that caution should be taken if routine reporting of CTAC images is to occur.

Citation

myocardial perfusion imaging

• Journal Article Type: Article
• Publication Date: Nov 30, 2016
• Deposit Date: Jun 1, 2017
• Publicly Available Date: Jul 3, 2017
• Journal: Diagnostic Imaging Europe
• Volume: Nov 16
• Pages: 53-55
• Publisher URL: http://www.dieurope.com/latest_news/a-review-of-the-issues-surrounding-incidental-findings-on-ctac-images
• Related Public URLs: http://www.dieurope.com/index.html