Multicentre analysis of incidental findings on low-resolution
CT attenuation correction images : an extended study

Coward, J; Lawson, R; Kane, T; Elias, M; Howes, A; Birchall, J; Hogg, P

Abstract

Objective: To review new incidental findings detected
on low-resolution CT attenuation correction (CTAC)
images acquired during single-photon emission CT-CT
myocardial perfusion imaging as an extension to our
initial study.
Methods: CTAC images acquired as part of myocardial
perfusion imaging performed using single-photon emission
CT at four UK nuclear medicine centres were evaluated as
part of a multicentre study. New incidental findings that
were considered to be clinically significant were evaluated
further. Positive-predictive value (PPV) was determined at
the time of definitive diagnosis.
Results: Out of 3485 patients, 962 (28%) patients had
a positive finding on the CTAC image, of which 824 (24%)
were new findings. 84 (2.4%) patients had findings
that were considered clinically significant at the time of
the CTAC report and which had not been previously
diagnosed. However, only 10 (0.29%) of these had
findings that were confirmed as clinically significant, with
the potential to be detrimental to patient outcome, after
follow-up and definitive diagnosis.
Conclusion: The overall PPV from all centres over the
2-year period was 12%. Each centre achieved what we
considered to be low PPVs with no significant difference
between the present and initial studies. The additional
data from the combined studies show that, statistically,
there is no significant difference between the PPVs from
any of the centres. We conclude that routine reporting of
CTAC images is not beneficial.
Advances in knowledge: This study combined with the
previous study offers a unique evaluation of new clinically
significant incidental findings on low-resolution CT images
in an attempt to determine the benefit of reporting the
CTAC images.

Citation

CT attenuation correction images : an extended study. British Journal of Radiology, 88(1056), https://doi.org/10.1259/bjr.20150555

• Journal Article Type: Article
• Acceptance Date: Oct 21, 2015
• Online Publication Date: Nov 16, 2015
• Publication Date: Nov 16, 2015
• Deposit Date: Dec 16, 2015
• Publicly Available Date: Nov 16, 2016
• Journal: British Journal of Radiology
• Print ISSN: 0007-1285
• Electronic ISSN: 1748-880X
• Publisher: British Institute of Radiology
• Volume: 88
• Issue: 1056
• DOI: https://doi.org/10.1259/bjr.20150555
• Publisher URL: http://dx.doi.org/10.1259/bjr.20150555
• Related Public URLs: http://www.birpublications.org/toc/bjr/current