Frequency and spectrum of incidental findings when using chest CT as a primary triage tool for COVID-19. (2021)

• Record Type: Journal Article
• Authors: Kilsdonk, Iris D.; de Roos, Marlise P.; Bresser, Paul; Reesink, Herre J.; Peringa, Jan
• Is Part Of: European journal of radiology open. Volume 8(2021)
• Publication Date: 2021
• Subjects: CAC coronary artery calcifications -- COVID-19 Coronavirus Disease 2019 -- CSU COVID-19 Screening Unit -- CT computer tomography -- IF incidental finding -- RT-PCR reverse transcriptase-polymerase chain reaction; COVID-19 -- Screening CT -- Chest CT -- Incidental findings; Medical radiology -- Periodicals; 616.075705
• DOI: 10.1016/j.ejro.2021.100366
• Languages: English
• ISSNs: 2352-0477

Abstract

Highlights: Of the 232 participants triaged with chest CT for COVID-19, 126 (54 %) showed one or more incidental findings (IF). 53 Participants (23 %) showed a potentially significant IF. A potentially significant IF requires further diagnostic or clinical work up. The most common potentially significant IFs were coronary artery calcifications, suspicious breast- and pulmonary nodules. Abstract: Purpose: To determine the prevalence and spectrum of incidental findings (IFs) identified in patients undergoing chest CT as a primary triage tool for COVID-19. Methods: In this study 232 patients were triaged in our COVID-19 Screening Unit by means of a chest CT (March 25–April 23, 2020). Original radiology reports were evaluated retrospectively for the description of IFs, which were defined as any finding in the report not related to the purpose of the scan. Documented IFs were categorized according to clinical relevance into minor and potentially significant IFs and according to anatomical location into pulmonary, mediastinal, cardiovascular, breast, upper abdominal and skeletal categories. IFs were reported as frequencies and percentages; descriptive statistics were used. Results: In total 197 IFs were detected in 126 patients (54 % of the participants). Patients with IFs were on average older (54.0 years old, SD 16.6) than patients without IFs (44.8 years old, SD 14.6, P < 0.05). In total 60 potentially significant IFs were detected in 53 patients (23 % of the participants). Most often reported were coronary artery calcifications (n = 23, 38 % of total potentially significant IFs/ 10 % of the total study population), suspicious breast nodules (n = 7, 12 % of total potentially significant IFs/ 3% of the total study population) and pulmonary nodules (n = 7, 12 % of total potentially significant IFs/ 3% of the total study population). Conclusion: A considerable number of IFs were detected by using chest CT as a primary triage tool for COVID-19, of which a substantial percentage (23 %) is potentially clinically relevant.