Learning objectives
Review the most common incidental findings on lung cancer screening CT (IFLCS).
Provide an easily accessible atlas organized by organs/structures of the most common IFLCS.
Understand how and when to suggest further action triggered by IFLCS.
Background
With the increase in number of ongoing lung cancer screening (LCS) programs worldwide, there is an increase in the detection of actionable or potentially significant incidental findings detected at lung cancer screening (IFLCS) in these patients.
IFLCS are a potential source of iatrogenic risk in otherwise healthy patients, if false positive findings result in unneeded biopsy procedures with potentially serious side effects and cost. There is no consensus as to the definition, reporting, or management of IFLCS, with some suggesting that only actionable findings should...
Findings and procedure details
On our screening program (Liverpool Healthy Lung Project), 3486 participants were enrolled form April 2016 to March 2109, of which 335 patients (9.6%) had IFLCS.
The IFLCS were organized by organ / location as: Lung, Heart, Mediastinum, Chest wall and Upper abdomen.
The great majority of these findings were lung-related (previous smoking-related history) such as emphysema or bronchial wall thickening. There were also significant IFLCS in 13 patients (0.37%) with extra-pulmonary malignancies (kidney, breast, lymphatic neoplasia, liver, thymus and pleura). Vascular findings were depicted in...
Conclusion
With this educational poster, we will illustrate and describe the most common IFLCS, organized by organ/structure and discuss the diagnostic work-up according to the importance and suspicion of the incidental finding.
Personal information and conflict of interest
D. Penha; Liverpool/UK - nothing to disclose E. Pinto; Liverpool/UK - nothing to disclose M. Ntouskou; Liverpool/UK - nothing to disclose C. Monaghan; Liverpool/UK - nothing to disclose M. D. McCreavy; Liverpool/UK - nothing to disclose L. Taborda; Covilhã/PT - nothing to disclose K. L. Irion; Manchester/UK - nothing to disclose M. Ledson; Liverpool/UK - nothing to disclose
References
Chung JH, Richards JC, Koelsch TL, et al, Screening for Lung Cancer: Incidental Pulmonary Parenchymal Findings. AJR Am J Roentgenol. 2018 Mar;210(3):503-513. doi: 10.2214/AJR.17.19003. Epub 2017 Dec 12. Review.
Morgan L, Choi H, Reid M, et al, Frequency of Incidental Findings and Subsequent Evaluation in Low-Dose Computed Tomographic Scans for Lung Cancer Screening.Ann Am Thorac Soc. 2017 Sep;14(9):1450-1456. doi: 10.1513/AnnalsATS.201612-1023OC.
Tsai EB, Chiles C, Carter BW, Godoy MCB, et al, Incidental Findings on Lung Cancer Screening: Significance and Management. Semin Ultrasound CT MR. 2018 Jun;39(3):273-281....