The prevalence of clinically relevant incidental findings on chest computed tomographic angiograms ordered to diagnose pulmonary embolism.

Background: Chest computed tomographic angiograms (CTAs) are frequently ordered for evaluation of suspected pulmonary embolism (PE) in the emergency department, but non-PE findings are often noted. Our objective was to determine the prevalence and management implications of incidental findings on chest CTAs ordered to assess for PE.

Methods: In a cross-sectional study, we reviewed 589 pulmonary CTAs that were ordered in the emergency department of a tertiary care hospital.

Helical computed tomography inaccuracy in the detection of pulmonary metastases: can it be improved?

Background: In thoracic surgery, manual lung palpation for detection of pulmonary metastases during resection is the standard of care, despite improvements in computed tomography (CT) imaging. In our previous study based on chart review alone, the accuracy of helical CT in the detection of pulmonary metastases was surprisingly low, with a sensitivity of 78%. We hypothesized that this may be improved by scan interpretation with adequate clinical history and focused documentation of all pulmonary lesions, and may be influenced by the training of the reader.

Accuracy of helical CT in the detection of pulmonary metastases: is intraoperative palpation still necessary?

Background: Pulmonary metastasectomy is well accepted in patients with isolated metastases from an extrathoracic malignancy. The standard approach involves careful intraoperative palpation of the lungs because more metastases are frequently found than were seen by preoperative conventional computed tomography (CT). Helical CT detects more nodules than conventional CT, raising the question of whether palpation of the lungs is still necessary if helical CT is used.