ArticleJournal of cardiovascular computed tomography
Incidental pulmonary nodules in emergent coronary CT angiography for suspected acute coronary syndrome: Impact of revised 2017 Fleischner Society Guidelines.
Article in Journal of cardiovascular computed tomography. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- The role of AI assistance in the evaluation of unenhanced chest CT scans in an emergency setting.Polish journal of radiology · 2026Article
- Development of a Pulmonary Nodule Service and Clinical Pathway: A Pragmatic Approach Addressing an Unmet Need.Diagnostics (Basel, Switzerland) · 2025Article
- Benign and malignant pulmonary parenchymal findings on chest CT among adult survivors of childhood and young adult cancer with a history of chest radiotherapy.Journal of cancer survivorship : research and practice · 2024Article
- Incidental pulmonary nodule management in Canada: exploring current state through a narrative literature review and expert interviews.Journal of thoracic disease · 2024Review
- Apical pulmonary lesions suspected of malignancy visible on neck CT angiography performed for acute stroke: Prevalence, treatment, and clinical implications - the PLEURA study.European stroke journal · 2023Review
- Unexpected extracardiac findings in cardiac computed tomography from neonates to young adults.Pediatric radiology · 2023Review
- Benign and Malignant Findings on Chest CT Among Adult Survivors of Childhood and Young Adult Cancer with a History of Chest Radiotherapy.Research square · 2023Article
- Lung cancer in the emergency department.Emergency cancer care · 2023Review
- The impact of cardiopulmonary hemodynamic factors in volumetry for pulmonary nodule management.BMC medical imaging · 2022Observational
- Incidental findings on cardiac computed tomography: No new emergencies to declare!Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2020Article
- Radiomics Improves Cancer Screening and Early Detection.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2020Review
- Developing a lung nodule management protocol specifically for cardiac CT: Methodology in the DISCHARGE trial.European journal of radiology open · 2020Article
- Artificial intelligence in cancer imaging: Clinical challenges and applications.CA: a cancer journal for clinicians · 2019Review
- Solid Indeterminate Pulmonary Nodules Less Than or Equal to 250 mmRadiology research and practice · 2019Article
- Incidental Non-cardiac Findings in Cardiovascular Imaging.Current treatment options in cardiovascular medicine · 2018Review
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Authors and funding
11 authors.
Funding
Abstract
backgroundPulmonary nodules (PN) are frequently detected incidentally during coronary computed tomography angiography (CTA). We evaluated whether the 2017 Fleischner Society guidelines may result in a decrease of follow-up testing of incidental PN as compared to prior guidelines in patients undergoing coronary CTA.
methodsWe conducted a retrospective study of a registry of emergency department patients who underwent coronary CTA for acute coronary syndrome assessment between 2012 and 2017. Based on guidelines, patients <35 years, history of cancer, or prior exams showing stability of PN were excluded. Patients >60 years, history of smoking, irregular/spiculated PN morphology, or PN size >20 mm were classified as high-risk for lung cancer. Radiological findings pertaining to PN were identified (PN size, morphology, quantity) through review of radiology reports. PN follow-up recommendations were established using 2017 Fleischner Society Guidelines and compared with prior guidelines for solid (2005) and subsolid (2013) PN. Data were analyzed with Student's t-test.
resultsThe registry included 2066 patients (female 45.1%, 52.9 ± 11.0 years), of which 578 (28.0%) reported PN. 438 of those (21.2%) were eligible for guideline-based follow-up evaluation. 205 (4 6.8%) were classified as high-risk for lung cancer. 2017 guidelines reduced the number of individuals requiring follow-up by 64.5%, from 264 (12.8%) to 94 patients (4.5%) when compared to prior guidelines (p < 0.001). The minimum number of follow-up chest CTs decreased by 55.8% from 430 to 190 (p < 0.001).
conclusionApplication of the 2017 Fleischner Society Guidelines resulted in a significant decrease of follow-up testing for incidental PN in patients undergoing coronary CTA for suspected acute coronary syndrome.
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