Incidence and Management of Cardiothoracic Relevant Extrapulmonary Findings found on Low Dose CTs.

BACKGROUND

We aim to investigate the incidence of extrapulmonary findings found on low-dose CT that may warrant evaluation by cardiothoracic surgeons and describe their management and referral patterns at our institution.

METHODS

We conducted a retrospective cohort study of patients who underwent low-dose CT through a centralized Lung Cancer Screening Program at Thomas Jefferson University Hospital between January 2018 and December 2022. Chart review using the electronic medical record was performed for patients with incidental findings. Demographic, workup, referral, and management data was collected.

RESULTS

2,285 patients underwent low-dose CT, of which 16% (368/2,285) had an extrapulmonary finding that may have an indication for clinical evaluation by a cardiothoracic surgeon. The most common incidental finding was a hiatal hernia with a prevalence of 6.3% (144/2,285), followed by ascending thoracic aneurysms with a prevalence of 3.6% (82/2,285), and small pericardial effusions with a prevalence of 1.2% (28/2,285). Of the patients with symptomatic hiatal hernias, 29% (14/48) were referred to a cardiothoracic surgeon compared to only 6.25% (6/96) in the asymptomatic group. Of the patients with thoracic aneurysms, 48% (39/82) had aneurysms ≥4.2 cm. Of the ≥4.2 cm group, 18% (7/39) were followed by a cardiothoracic surgeon compared to 11.6% (5/43) in patients with aneurysms < 4.2 cm.

CONCLUSIONS

Hiatal hernias and ascending thoracic aneurysms were the two most prevalent incidental findings identified on low-dose CT during lung cancer screening. We demonstrated potential gaps in hiatal hernia referral patterns. Referring patients with thoracic aneurysms to cardiothoracic surgeons may not be initially warranted.

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.