Yap Kelvin Kwok-Ho, Ramaseshan Ganesh, Sutherland Tom, Shafik-Eid Raymond, Taubman Kim, Schlicht Stephen
Medical Imaging Department, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
J Med Imaging Radiat Oncol. 2015 Feb;59(1):26-33. doi: 10.1111/1754-9485.12254. Epub 2014 Nov 20.
In nuclear medicine, single-photon-emission computed tomography (SPECT) is often combined with 'simultaneous' low-dose CT (LDCT) to provide complementary anatomical and functional correlation. As a consequence, numerous incidental and unexpected findings may be detected on LDCT. Recognition of these findings and appropriate determination of their relevance can add to the utility of SPECT/CT. We aimed to evaluate the prevalence and categorise the relevance of incidental and unexpected findings on LDCT scans performed as part of routine SPECT/CT studies.
All available LDCT scans performed as part of SPECT/CT studies at St. Vincent's Hospital Melbourne in the year 2013 were retrospectively reviewed. Two qualified radiologists independently reviewed the studies and any previous available imaging and categorised any detected incidental findings.
A total of 2447 LDCT studies were reviewed. The relevance of the findings was classified according to a modified version of a scale used in the Colonography Reporting and Data System: E1 = normal or normal variant (28.0%); E2 = clinically unimportant (63.5%); E3 = likely unimportant or incompletely characterised (6.2%); E4 = potentially important (2.5%).
Imaging specialists need to be cognisant of incidental and unexpected findings present on LDCT studies performed as part of SPECT/CT. Appropriate categorisation of findings and communication of potentially important findings to referring clinicians should form part of routine practice. The overall prevalence of potentially significant incidental and unexpected findings in our series was 8.7% (E3, 6.2%; E4, 2.5%) and was comparable to rates in other published imaging series.
在核医学中，单光子发射计算机断层扫描（SPECT）常与“同步”低剂量CT（LDCT）相结合，以提供互补的解剖结构与功能相关性。因此，在LDCT上可能会检测到许多偶然和意外的发现。识别这些发现并适当确定其相关性可增加SPECT/CT的实用性。我们旨在评估作为常规SPECT/CT研究一部分所进行的LDCT扫描中偶然和意外发现的患病率，并对其相关性进行分类。
回顾性分析了2013年在墨尔本圣文森特医院作为SPECT/CT研究一部分所进行的所有可用LDCT扫描。两名合格的放射科医生独立审查了这些研究以及之前可用的影像资料，并对检测到的任何偶然发现进行了分类。
共审查了2447项LDCT研究。根据结肠造影报告和数据系统中使用的量表的修改版本对发现的相关性进行分类：E1 =正常或正常变异（28.0%）；E2 =临床不重要（63.5%）；E3 =可能不重要或特征不完全明确（6.2%）；E4 =潜在重要（2.5%）。
影像专家需要了解作为SPECT/CT一部分所进行的LDCT研究中存在的偶然和意外发现。对发现进行适当分类并将潜在重要发现告知转诊临床医生应成为常规操作的一部分。在我们的系列研究中，潜在重大偶然和意外发现的总体患病率为8.7%（E3，6.2%；E4，2.5%），与其他已发表的影像系列中的患病率相当。
