{
  "abstract": "Background Extracardiac findings (ECF) are frequently detected on cardiac computed tomography (CT), yet their documentation and follow-up remain variable. We aimed to determine the prevalence of clinically significant ECF and evaluate rates of documented follow-up across different cardiac CT indications.Methods We performed a retrospective study of consecutive patients undergoing CT coronary angiography (CTCA) and CT left atrial mapping (CTLA) at a tertiary centre between January 2021 and December 2022. ECF were extracted from formal reports and classified according to guideline-directed criteria. Clinically significant findings were defined as those requiring further investigation, surveillance, or treatment. Electronic medical records were reviewed to assess documentation and follow-up within the hospital network.Results A total of 402 patients were included. ECF were identified in 87.1% of scans. Overall, 10.2% of scans demonstrated ≥1 clinically significant ECF (44 findings across 41 patients), most commonly pulmonary nodules ≥6 mm and pulmonary emboli. Of these findings, 29.2% of clinically significant ECF had no documented follow-up. CTLA was associated with a higher prevalence of clinically significant findings compared with CTCA (18.6% vs 8.7%; OR 2.4, 95% CI 1.1–5.1; p = 0.03) and lower rates of documented follow-up (54.5% vs 20.0%; OR 4.8, 95% CI 1.1–21.2; p = 0.05). Missed follow-up occurred predominantly in outpatient pre-procedural pathways (table 1).Conclusions Clinically significant extracardiac findings are identified in approximately 1 in 10 cardiac CT studies, with variability in the documentation of follow-up. Structured reporting and closed-loop communication systems may support consistent recognition and management of incidental findings. Question: In patients undergoing cardiac CT, what proportion of scans demonstrate at last one clinically significant extracardiac finding?a) 1-2%b) 5%c) 10%d) 20%e) 40%Abstract 24 Table 1Clinically significant findings by scan typeClinically significant findings CTCA (n=343) CTLA (n=59) Total n (%) Patients with ≥1 clinically significant finding 30 (8.7%) 11 (18.6%)41 (10.2%) Pulmonary findings 181028 (7.0%) Multiple pulmonary nodules <6 mm * 1 1 2 (0.5%) Pulmonary nodules 6-8mm5 6 11 (2.7%) Pulmonary nodules >8mm73 10 (2.5%) Pulmonary embolus 5 0 5 (1.2%)Abdominal findings 909 (2.2%) Indeterminate liver lesion 606 (1.5%) Adrenal lesion 2 02 (0.5%) Indeterminate splenic lesion 1 01 (0.2%) Other findings 527 (1.7%) Bone lesions (lytic/mass)404 (1.0%) Breast nodule 1 1 2 (0.5%) Anterior mediastinal mass 01 1 (0.2%) *High-risk patients requiring surveillance. A total of 44 clinically significant findings were identified across 41 patients, with some patients having multiple findings.Correct answer: C. 10%.",
  "authors": [
    {
      "affiliations": [
        "Royal Brisbane and Women’s Hospital, Herston, QLD 4029",
        "Faculty of Medicine, The University of Queensland, St Lucia, QLD"
      ],
      "name": "Jennifer Sun"
    },
    {
      "affiliations": [
        "Royal Brisbane and Women’s Hospital, Herston, QLD 4029"
      ],
      "name": "Kristyan Guppy-Coles"
    },
    {
      "affiliations": [
        "Royal Brisbane and Women’s Hospital, Herston, QLD 4029"
      ],
      "name": "Paul Tesar"
    },
    {
      "affiliations": [
        "Royal Brisbane and Women’s Hospital, Herston, QLD 4029",
        "Faculty of Medicine, The University of Queensland, St Lucia, QLD"
      ],
      "name": "Jason Davis"
    },
    {
      "affiliations": [
        "Royal Brisbane and Women’s Hospital, Herston, QLD 4029",
        "Faculty of Medicine, The University of Queensland, St Lucia, QLD"
      ],
      "name": "John F Younger"
    },
    {
      "affiliations": [
        "Royal Brisbane and Women’s Hospital, Herston, QLD 4029"
      ],
      "name": "Paul Martin"
    }
  ],
  "title": "24 Clinically significant extracardiac findings on cardiac CT: prevalence and gaps in follow-up across imaging pathways",
  "uid": "d2ce679f-a979-51d6-95e4-93e558e1627b"
}