The Pros and Cons of Searching for Extracardiac Findings at Cardiac CT: Studies Should Be Reconstructed in the Maximum Field of View and Adequately Reviewed to Detect Pathologic Findings

Radiology: Volume 261: Number 2-November 2011

James P. Earls, MD

Incidental extracardiac findings are commonly depicted at cardiac com-puted tomographic (CT) examinations (1-15). The cross-sectional nature of cardiac CT, performed as both electron-beam CT and multi-detector row CT, produces images that include portions of the lungs, chest wall, mediastinum, and upper abdomen. Extracardiac findings occasionally account for the patient's chief complaint, but more commonly, the findings are incidental and unrelated to symptoms. Further investigation or imaging follow-up of these findings can sometimes be costly, may increase pa­tients' cumulative radiation dose, and are considered by some as unnecessar­ily contributing to patient and referring physician stress without proved health benefit (16,17). Several authors have concluded that cardiac CT studies should only be reconstructed with a small field of view (FOV) to decrease detection of extracardiac findings (11,16,17).