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Review
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Korean J Med. 2006;71(1):286-286.
- Non-cardiac Findings on 64-slice Cardiac MDCT comparison between Single Cardiac CT and additional Chest CT protocol
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- Non-cardiac Findings on 64-slice Cardiac MDCT comparison between Single Cardiac CT and additional Chest CT protocol
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1Department of Internal Medicine, Hanyang University College of Medicine, Seoul; 2Department of Life Science, Postech Biotech Center, Pohang University of Science and Technology, Pohang, Korea
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- Abstract
- OBJECTIVES 64-slice MDCT is becoming more common as a diagnostic tool for cardiac diseases. MDCT is also known to
detect significant number of non-cardiac findings during cardiac work-up. However, significant non-cardiac findings might be
missed when we limit field-of-view (FOV) to cardiac structure. The objective of this study was to estimate the prevalence of
non-cardiac findings and risk and benefit of cardiac MDCT according to protocols.METHODS We enrolled 1,194 consecutive
subjects (49.4±9.7 years, 62.5% men) underwent coronary artery disease screening with 64-slice MDCT. First, patients were
scanned using ECG-gated coronary CT Angiography technique from the level of pulmonary arteries through the base of heart
(cardiac FOV) and then additional chest scan was performed using non-gated chest CT technique from the level of thoracic inlet
through kidney (thoracic FOV). We compared the frequency of non-cardiac findings and the exposed radiation dose between
single cardiac CT (cardiac FOV) and additional chest CT protocol (thoracic FOV).RESULTS In additional chest CT protocol,
total of 1,461 incidental non-cardiac findings were identified in 851 patients (71.3%). A total of 75 patients (6.2%) had clinically
significant findings, requiring further diagnostic work-up: 42, non-calcified nodule < 10mm; 2, non-calcified nodule ≥ 10mm;
5, pulmonary infiltrates; 14, mass other than lung; and 12, other lesions. Four cases (0.3%) of malignancy were detected at
surgically treatable stage except one case. In single cardiac CT protocol, 29 patients (38.7%) with significant lesions were missed
including 3 cases of malignancy. The mean effective dose of radiation in single cardiac CT protocol (14.0±2.2 mSv) was less
than that for additional chest CT protocol (20.2±2.0 mSv). The expected lifetime risk of cancer increased to 0.03% by additional
scan (0.07% vs. 0.10%).CONCLUSIONS In a population referred for cardiac MDCT, significant non-cardiac findings ( 6.2%) were
detected by additional chest CT protocol. Considering significant number of non-cardiac findings and acceptable radiation hazard
risk, protocol with extended FOV is preferred in patient with suspected cardiac disease.
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