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

被引:13
作者
Nakamura, Naoki [1 ]
Tsunoda, Hiroko [2 ]
Takahashi, Osamu [3 ]
Kikuchi, Mari [2 ]
Honda, Satoshi [2 ]
Shikama, Naoto [4 ]
Akahane, Keiko
Sekiguchi, Kenji
机构
[1] St Lukes Int Hosp, Dept Radiat Oncol, Chuou Ku, Tokyo 1048560, Japan
[2] St Lukes Int Hosp, Dept Radiol, Tokyo 1048560, Japan
[3] St Lukes Int Hosp, Dept Med, Div Gen Internal Med, Tokyo 1048560, Japan
[4] Saitama Med Univ, Int Med Ctr, Dept Radiat Oncol, Hidaka, Japan
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2012年 / 84卷 / 03期
关键词
Breast cancer; CT simulation; Diagnostic radiologist; Incidental findings; Radiotherapy; CHEST-WALL IRRADIATION; RADIATION-THERAPY; CT;
D O I
10.1016/j.ijrobp.2011.12.075
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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. (C) 2012 Elsevier Inc.
引用
收藏
页码:602 / 605
页数:4
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