Patient-centered clinical impact of incidentally detected abnormalities on chest CT scans

Purpose To demonstrate the spectrum of incidental findings on chest CT scans and to evaluate the clinical impact of significant different abnormalities on patient management. Materials and methods This retrospective study included incidental findings on chest CT scans from an adult patient population, performed at the University of Washington, within a 10 month period. After exclusion of repetitive findings, 113 patients (50 males and 63 females, age 18-96 years, mean = 57.3 years) demonstrated 163 uniquely different findings. We determined the clinical significance according to the need for further workup and/or therapy. The gold standard for diagnosis was either by pathologic proof, follow up CT, or other imaging modalities. Results 38 different findings were judged clinically significant (10.4%) requiring further workup and/or therapy in 9.6% and 7.1%, respectively. The anatomic site of disease was: intra-thoracic (n = 27, 71.1%), extra-thoracic (n = 5, 13.1%), lower neck (n = 3, 7.9%), and upper abdomen (n = 3, 7.9%). They included 12 unique malignant pathologies (31.6%), and 26 non-malignant findings (68.4%). Conclusion The clinically significant different incidental abnormalities on chest CT scans represented 10.4% of all incidental findings, 3.3% were due to malignancies. The clinical impact of incidental abnormalities on chest CT may be of utmost importance on patient care.