In the past, preoperative chest radiograph was included in many centers for routine anesthesiologic evaluation, since it is a relatively low-cost and low-risk procedure to screen or evaluate for occult or known cardiopulmonary disease [1, 2]. However, several recently published studies concluded that routine chest radiograph should be avoided before elective surgical procedures [3]. It comes up that chest radiographs identify a lot of no serious abnormalities because surgical population is low-risk for cardio-pulmonary diseases [1]. Due to the prevalence of chest abnormalities increases with...

We reviewed retrospectively 1700 preoperative chest radiographs, performed in our Unit from January to November 2012 and evaluated by 5 experienced radiologists. Based on the need of further investigations, pleuro-parechymal incidental findings were classified into two categories: 1) unremarkable, which not deserving further investigations (fibro-calcific micronodules, pleuro-parenchymal fibrocalcifications); 2) significant, that requiring further investigations (nodular opacities, pulmonary condensations, non-calcified micronodules, pulmonary interstitial diseases, pleural effusions) [Tab.1].

Among 1700, 919 chest radiograph were negative due to the lack of incidental findings [Fig.1]. In the remaining 781 patients, incidental findings were identified and classified 700 in category 1 (89,6%), and 81 in category 2 (10,4%), which required comparison with previous examinations, correlation with clinical data and/or follow-up (75%), or CT scan (25%) [Fig.2]. Furthermore the findings in category 2, were subclassified as follows: 29 nodular opacities (14 inflammation sequelaes, 6 cancers, 1 amyloidosis, 1 small airway inflammation); 25 pulmonary condensations (10 pneumonia, 7...

The use of the preoperative chest radiograph is recommended for patients over 45 years of age, with other risk factors, such as cardiopulmonary comorbidities and severe systemic illnesses, on the basis of preanesthetic history and/or clinical signs and symptoms. In this context, the preoperative clinical assessment is crucial for determining when patients need to undergo any diagnostic procedures. Morevoer, chest radiograph obtained within 6 months of surgery are generally acceptable if the patient’s medical history has not changed [3]. In our group, the frequency of...

[1] Mohammed TL, Kirsch J, Amorosa JK, Brown K, Chung JH, Dyer DS, Ginsburg ME, Heitkamp DE, Kanne JP, Kazerooni EA, Ketai LH, Ravenel JG, Saleh AG, Shah RD, Expert Panel on Thoracic Imaging. ACR Appropriateness Criteria® routine admission and preoperative chest radiography. [online publication]. Reston (VA): American College of Radiology (ACR); 2011. 6 p. [2] Joo HS, Wong J, Naik VN, Savoldelli GL. The value of screening preoperative chest x-rays: a systematic review. Can J Anaesth. 52, 568-574, 2005. [3] Calderini E, Adrario E,...