This Article Full Text Full Text (PDF) All Versions of this Article: 106/5/532    most recent 01.CIR.0000027136.56615.DEv1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Horton, K. M. Articles by Fishman, E. K. Search for Related Content PubMed PubMed Citation Articles by Horton, K. M. Articles by Fishman, E. K. Pubmed/NCBI databases Medline Plus Health Information Coronary Artery Disease CT Scans Lung Cancer Related Collections Coronary imaging: angiography/ultrasound/Doppler/CC CT and MRI

(Circulation. 2002;106:532.)
© 2002 American Heart Association, Inc.

Brief Rapid Communications

Prevalence of Significant Noncardiac Findings on Electron-Beam Computed Tomography Coronary Artery Calcium Screening Examinations

From the Department of Radiology, Johns Hopkins Medical Institutions (K.M.H., E.K.F.), and the Department of Medicine, Johns Hopkins University (W.S.P., R.S.B.), Baltimore, Md.

Correspondence to Karen M. Horton, MD, Johns Hopkins Medical Institutions, 601 N Caroline St, Room 3253, Baltimore, MD 21287. E-mail kmhorton{at}jhmi.edu

Background— Screening electron-beam computed tomography (EBCT) examinations for the detection and quantification of coronary artery calcification are being performed throughout the country. In addition to information about the heart, great vessels, and coronary arteries, these examinations include portions of the lungs, bony thorax, and upper abdomen. The purpose of this study was to determine the prevalence of significant noncardiac findings in a series of patients undergoing coronary artery calcification screening studies with EBCT scanning.

Methods and Results— Between January 1, 2001, and October 1, 2001, 1326 consecutive patients underwent coronary artery calcification screening with EBCT (3-mm-thick slices were obtained at 3-mm intervals). Two board-certified radiologists reviewed the examinations on a workstation using standard mediastinal windows, lung windows, and bone windows. Significant extracardiac abnormalities were noted. Of 1326 patients, 103 (7.8%) had significant extracardiac pathology requiring clinical or imaging follow-up. These included 53 patients with noncalcified lung nodules <1 cm, 12 patients with lung nodules 1 cm, 24 patients with infiltrates, 7 patients with indeterminate liver lesions, 2 patients with sclerotic bone lesions, 2 patients with breast abnormalities, 1 patient with polycystic liver disease, 1 patient with esophageal thickening, and 1 patient with ascites.

Conclusions— In this study, 7.8% of patients undergoing screening EBCT examinations for coronary artery calcification were found to have important extracardiac pathology requiring additional work-up. Therefore, it is essential that a radiologist review the entire examination.

Key Words: calcium • radiography • computed tomography

This article has been cited by other articles:

				J. R. Burt, C. Iribarren, J. M. Fair, L. C. Norton, M. Mahbouba, G. D. Rubin, M. A. Hlatky, A. S. Go, S. P. Fortmann, and for the Atherosclerotic Disease, Vascular Function Incidental Findings on Cardiac Multidetector Row Computed Tomography Among Healthy Older Adults: Prevalence and Clinical Correlates Arch Intern Med, April 14, 2008; 168(7): 756 - 761. [Abstract] [Full Text] [PDF]

				T. M. Bateman Business Aspects of Cardiovascular Computed Tomography: Tackling the Challenges J. Am. Coll. Cardiol. Img., January 1, 2008; 1(1): 111 - 118. [Abstract] [Full Text] [PDF]

				J. Mueller, J. Jeudy, R. Poston, and C. S. White Cardiac CT Angiography After Coronary Bypass Surgery: Prevalence of Incidental Findings Am. J. Roentgenol., August 1, 2007; 189(2): 414 - 419. [Abstract] [Full Text] [PDF]

				S. Goetze, H. K. Pannu, and R. L. Wahl Clinically Significant Abnormal Findings on the "Nondiagnostic" CT Portion of Low-Amperage-CT Attenuation-Corrected Myocardial Perfusion SPECT/CT Studies J. Nucl. Med., August 1, 2006; 47(8): 1312 - 1318. [Abstract] [Full Text] [PDF]

				Y. Onuma, K. Tanabe, G. Nakazawa, J. Aoki, H. Nakajima, K. Ibukuro, and K. Hara Noncardiac Findings in Cardiac Imaging With Multidetector Computed Tomography J. Am. Coll. Cardiol., July 18, 2006; 48(2): 402 - 406. [Abstract] [Full Text] [PDF]

				J. A. Rumberger Noncardiac Abnormalities in Diagnostic Cardiac Computed Tomography: Within Normal Limits or We Never Looked! J. Am. Coll. Cardiol., July 18, 2006; 48(2): 407 - 408. [Full Text] [PDF]

				S. Haller, C. Kaiser, P. Buser, G. Bongartz, and J. Bremerich Coronary artery imaging with contrast-enhanced MDCT: extracardiac findings. Am. J. Roentgenol., July 1, 2006; 187(1): 105 - 110. [Abstract] [Full Text] [PDF]

				M. E. Clouse, J. Chen, H. M. Krumholz, M. E. Clouse, J. Chen, and H. M. Krumholz Noninvasive Screening for Coronary Artery Disease With Computed Tomography Is Useful Circulation, January 3, 2006; 113(1): 125 - 146. [Full Text] [PDF]

				C. D. Furtado, D. A. Aguirre, C. B. Sirlin, D. Dang, S. K. Stamato, P. Lee, F. Sani, M. A. Brown, D. L. Levin, and G. Casola Whole-Body CT Screening: Spectrum of Findings and Recommendations in 1192 Patients Radiology, November 1, 2005; 237(2): 385 - 394. [Abstract] [Full Text] [PDF]

				F. S. Apple, A. H.B. Wu, J. Mair, J. Ravkilde, M. Panteghini, J. Tate, F. Pagani, R. H. Christenson, M. Mockel, O. Danne, et al. Future Biomarkers for Detection of Ischemia and Risk Stratification in Acute Coronary Syndrome Clin. Chem., May 1, 2005; 51(5): 810 - 824. [Abstract] [Full Text] [PDF]

				C. Hong, T. K. Pilgram, F. Zhu, and K. T. Bae Coronary Artery Calcification: Effect of Size of Field of View on Multi-Detector Row CT Measurements Radiology, October 1, 2004; 233(1): 281 - 285. [Abstract] [Full Text] [PDF]

				M. Panteghini Role and importance of biochemical markers in clinical cardiology Eur. Heart J., July 2, 2004; 25(14): 1187 - 1196. [Abstract] [Full Text] [PDF]

				F. M. Vogt, C. U. Herborn, P. Hunold, T. C. Lauenstein, T. Schroder, J. F. Debatin, and J. Barkhausen HASTE MRI Versus Chest Radiography in the Detection of Pulmonary Nodules: Comparison with MDCT Am. J. Roentgenol., July 1, 2004; 183(1): 71 - 78. [Abstract] [Full Text] [PDF]

				J. J. Fenton and R. A. Deyo Patient Self-Referral for Radiologic Screening Tests: Clinical and Ethical Concerns J Am Board Fam Med, November 1, 2003; 16(6): 494 - 501. [Abstract] [Full Text] [PDF]

				P. Greenland and J. M. Gaziano Selecting Asymptomatic Patients for Coronary Computed Tomography or Electrocardiographic Exercise Testing N. Engl. J. Med., July 31, 2003; 349(5): 465 - 473. [Full Text] [PDF]

				P. G. O'Malley, I. M. Feuerstein, and A. J. Taylor Impact of Electron Beam Tomography, With or Without Case Management, on Motivation, Behavioral Change, and Cardiovascular Risk Profile: A Randomized Controlled Trial JAMA, May 7, 2003; 289(17): 2215 - 2223. [Abstract] [Full Text] [PDF]

				A. P. Bolger, K. M. Horton, E. K. Fishman, W. S. Post, and R. S. Blumenthal When Does Serendipity Become Screening? The Deliberate Search for Noncardiac Pathology on Electron-Beam Computed Tomography * Response Circulation, February 25, 2003; 107 (7): e54 - e54. [Full Text] [PDF]