Assessing the Prevalence of Incidental Findings Identified by CTPA in Women of Reproductive Age

Background and Objective. Tough multiple studies have evaluated the prevalence of incidental fndings identifed by CTPA, none have done so with a focus on reproductive-age females with normal chest X-ray (CXR). Due to a comparatively lower breast radiation dose, the of-recommended alternative to CTPA in this patient group is a V/Q scan. However, these are limited in their assessment of these alternate fndings; therefore, it is of particular importance to evaluate the likelihood of these fndings on CT in this patient group, which is the goal of this study. Methods. Trough a review of our PACS system, female patients aged 18-50 years who underwent diagnostic CTPA prior to April 1, 2017, were identifed. Te 100 most recent cases which had a normal CXR within 48 hours of CTPA were included. Incidental/non-PE fndings were then divided into PE-positive (PE+) and PE-negative (PE-), and subcategorized into types I, II, III, and nil non-PE fnding groups. Type I fndings required immediate follow-up or intervention, type II fndings required outpatient follow-up, and type III fndings required no follow-up or were previously known. Results. PE was detected in 15% of scans. Type I fndings were found in 8% of patients (0% of PE+, 9.4% of PE-), type II fndings in 10% of patients (13.3% of PE+, 9.4% of PE-), type III fndings in 34% of patients (40% of PE+, 32.9% of PE-), and nil non-PE fnding in 48% of patients (46.7% PE+, 48.2% of PE-). Conclusion. While CTPA identifes incidental fndings in the majority of patients, a small minority of these fndings are likely to alter immediate management. In the context in increased radiation risk, this strengthens the argument that alternate imaging modalities such as V/Q should be strongly considered for the investigation of potential PE in women of reproductive age with normal CXR.