Multi-centre analysis of incidental findings on low-resolution CT attenuation correction images

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 (SPECT-CT) myocardial
perfusion imaging (MPI) and to determine whether
the CTAC images had diagnostic value and warrant reporting.

Methods: A multicentre study was performed in four UK
nuclear medicine departments. CTAC images acquired
as part of MPI performed using SPECT were evaluated to
identify incidental findings. New findings considered to
be clinically significant were evaluated further. Positive
predictive value (PPV) was determined at the time of
definitive diagnosis.

Results: Of 1819 patients studied, 497 (27.3%) had a
positive CTAC finding. 51 (2.8%) patients had findings
that were clinically significant at the time of the CTAC
report and had not been previously diagnosed. Only
four (0.2%) of these were potentially detrimental to
patient outcome.

Conclusion: One centre had a PPV of 0%, and the study
suggests that these CTAC images should not be reported.
Two centres with more modern equipment had low
PPVs of 0% and 6%, respectively, and further research is
suggested prior to drawing a conclusion. The centre with
best quality CT had a PPV of 67%, and the study suggests
that CTAC images from this equipment should be reported.
Advances in knowledge: This study is unique compared
with previous studies that have reported only the potential
to identify incidental findings on low-resolution CT images.
This study both identifies and evaluates new clinically
significant incidental findings, and it demonstrates that
the benefit of reporting the CTAC images depends on
the type of equipment used.

Citation

Coward, J., Lawson, R., Kane, T., Elias, M., Howes, A., Birchall, J., & Hogg, P. (2014). Multi-centre analysis of incidental findings on low-resolution CT attenuation correction images. British Journal of Radiology, 87(1042), https://doi.org/10.1259/bjr.20130701

• Journal Article Type: Article
• Acceptance Date: Aug 14, 2014
• Online Publication Date: Sep 16, 2014
• Publication Date: Sep 16, 2014
• Deposit Date: Sep 19, 2014
• Publicly Available Date: Oct 8, 2018
• Journal: British Journal of Radiology
• Print ISSN: 0007-1285
• Electronic ISSN: 1748-880X
• Publisher: British Institute of Radiology
• Peer Reviewed: Peer Reviewed
• Volume: 87
• Issue: 1042
• DOI: https://doi.org/10.1259/bjr.20130701
• Publisher URL: http://dx.doi.org/10.1259/bjr.20130701
• Related Public URLs: http://www.bir.org.uk/publications/journals/