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Title: Frequency and Clinical Significance of Previously Undetected Incidental Findings Detected on Computed Tomography Simulation Scans for Breast Cancer Patients

Abstract

Purpose: To determine the frequency and clinical significance of previously undetected incidental findings found on computed tomography (CT) simulation images for breast cancer patients. Methods and Materials: All CT simulation images were first interpreted prospectively by radiation oncologists and then double-checked by diagnostic radiologists. The official reports of CT simulation images for 881 consecutive postoperative breast cancer patients from 2009 to 2010 were retrospectively reviewed. Potentially important incidental findings (PIIFs) were defined as any previously undetected benign or malignancy-related findings requiring further medical follow-up or investigation. For all patients in whom a PIIF was detected, we reviewed the clinical records to determine the clinical significance of the PIIF. If the findings from the additional studies prompted by a PIIF required a change in management, the PIIF was also recorded as a clinically important incidental finding (CIIF). Results: There were a total of 57 (6%) PIIFs. The 57 patients in whom a PIIF was detected were followed for a median of 17 months (range, 3-26). Six cases of CIIFs (0.7% of total) were detected. Of the six CIIFs, three (50%) cases had not been noted by the radiation oncologist until the diagnostic radiologist detected the finding. On multivariate analysis, previous CTmore » examination was an independent predictor for PIIF (p = 0.04). Patients who had not previously received chest CT examinations within 1 year had a statistically significantly higher risk of PIIF than those who had received CT examinations within 6 months (odds ratio, 3.54; 95% confidence interval, 1.32-9.50; p = 0.01). Conclusions: The rate of incidental findings prompting a change in management was low. However, radiation oncologists appear to have some difficulty in detecting incidental findings that require a change in management. Considering cost, it may be reasonable that routine interpretations are given to those who have not received previous chest CT examinations within 1 year.« less

Authors:
 [1];  [2];  [3]; ;  [2];  [4]; ;  [1]
  1. Department of Radiation Oncology, St. Luke's International Hospital, Tokyo (Japan)
  2. Department of Radiology, St. Luke's International Hospital, Tokyo (Japan)
  3. Division of General Internal Medicine, Department of Medicine, St. Luke's International Hospital, Tokyo (Japan)
  4. Department of Radiation Oncology, Saitama Medical University International Medical Center, Hidaka (Japan)
Publication Date:
OSTI Identifier:
22149554
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 84; Journal Issue: 3; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHEST; COMPUTERIZED TOMOGRAPHY; HEALTH HAZARDS; IMAGES; MAMMARY GLANDS; MEDICAL PERSONNEL; MULTIVARIATE ANALYSIS; NEOPLASMS; PATIENTS; RADIOTHERAPY; SIMULATION

Citation Formats

Nakamura, Naoki, E-mail: naokinak@luke.or.jp, Tsunoda, Hiroko, Takahashi, Osamu, Kikuchi, Mari, Honda, Satoshi, Shikama, Naoto, Akahane, Keiko, and Sekiguchi, Kenji. Frequency and Clinical Significance of Previously Undetected Incidental Findings Detected on Computed Tomography Simulation Scans for Breast Cancer Patients. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.12.075.
Nakamura, Naoki, E-mail: naokinak@luke.or.jp, Tsunoda, Hiroko, Takahashi, Osamu, Kikuchi, Mari, Honda, Satoshi, Shikama, Naoto, Akahane, Keiko, & Sekiguchi, Kenji. Frequency and Clinical Significance of Previously Undetected Incidental Findings Detected on Computed Tomography Simulation Scans for Breast Cancer Patients. United States. doi:10.1016/J.IJROBP.2011.12.075.
Nakamura, Naoki, E-mail: naokinak@luke.or.jp, Tsunoda, Hiroko, Takahashi, Osamu, Kikuchi, Mari, Honda, Satoshi, Shikama, Naoto, Akahane, Keiko, and Sekiguchi, Kenji. Thu . "Frequency and Clinical Significance of Previously Undetected Incidental Findings Detected on Computed Tomography Simulation Scans for Breast Cancer Patients". United States. doi:10.1016/J.IJROBP.2011.12.075.
@article{osti_22149554,
title = {Frequency and Clinical Significance of Previously Undetected Incidental Findings Detected on Computed Tomography Simulation Scans for Breast Cancer Patients},
author = {Nakamura, Naoki, E-mail: naokinak@luke.or.jp and Tsunoda, Hiroko and Takahashi, Osamu and Kikuchi, Mari and Honda, Satoshi and Shikama, Naoto and Akahane, Keiko and Sekiguchi, Kenji},
abstractNote = {Purpose: To determine the frequency and clinical significance of previously undetected incidental findings found on computed tomography (CT) simulation images for breast cancer patients. Methods and Materials: All CT simulation images were first interpreted prospectively by radiation oncologists and then double-checked by diagnostic radiologists. The official reports of CT simulation images for 881 consecutive postoperative breast cancer patients from 2009 to 2010 were retrospectively reviewed. Potentially important incidental findings (PIIFs) were defined as any previously undetected benign or malignancy-related findings requiring further medical follow-up or investigation. For all patients in whom a PIIF was detected, we reviewed the clinical records to determine the clinical significance of the PIIF. If the findings from the additional studies prompted by a PIIF required a change in management, the PIIF was also recorded as a clinically important incidental finding (CIIF). Results: There were a total of 57 (6%) PIIFs. The 57 patients in whom a PIIF was detected were followed for a median of 17 months (range, 3-26). Six cases of CIIFs (0.7% of total) were detected. Of the six CIIFs, three (50%) cases had not been noted by the radiation oncologist until the diagnostic radiologist detected the finding. On multivariate analysis, previous CT examination was an independent predictor for PIIF (p = 0.04). Patients who had not previously received chest CT examinations within 1 year had a statistically significantly higher risk of PIIF than those who had received CT examinations within 6 months (odds ratio, 3.54; 95% confidence interval, 1.32-9.50; p = 0.01). Conclusions: The rate of incidental findings prompting a change in management was low. However, radiation oncologists appear to have some difficulty in detecting incidental findings that require a change in management. Considering cost, it may be reasonable that routine interpretations are given to those who have not received previous chest CT examinations within 1 year.},
doi = {10.1016/J.IJROBP.2011.12.075},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 84,
place = {United States},
year = {2012},
month = {11}
}