Ilan Gottlieb MD, Abstract Co-Author: Research grant, Toshiba Corporation

Marc Dewey MD, Abstract Co-Author: Research grant, General Electric Company (Amersham plc) Research grant, Bracco ALTANA Pharma GmbH Research grant, Toshiba Corporation Speakers Bureau, Toshiba Corporation Speakers Bureau, Bayer AG (Berlex Inc)

Julie Miller MD, Abstract Co-Author: Research grant, Toshiba Corporation

Melvin E. Clouse MD, Abstract Co-Author: Nothing to Disclose

Joao A.C. Lima MD, Abstract Co-Author: Grant, Toshiba Corporation Grant, Bracco Group Grant, General Electric Company Grant, Astellas Group

Narinder S. Paul MD, Presenter: Research grant, Toshiba Corporation

We studied a preliminary cohort of patients enrolled in the CorE 64 prospective multi-center trial comparing coronary CTA to conventional coronary angiography (CCA) to determine the frequency and clinical importance of extra-cardiac findings.

397 patients had coronary CTA performed. All CT scans were reconstructed at full field of view using high and low spatial frequency filters and read by a radiologist. The findings were categorized as: 1: No abnormal findings; 2: Potential clinical consequences, but no follow-up recommended (i.e. lung blebs); 3: Potential clinical consequences, follow-up indicated (i.e. lung or hepatic nodules); 4: Serious disorder requiring immediate attention (i.e. pulmonary embolism).

337 patients have been analyzed to date (mean age 60±9 years). 193 (57%) had no abnormalities (category 1); 77 (23%) had abnormal findings that did not require follow up (category 2); 62 (18.4%) had findings that required follow up (category 3) and 4 (1.2 %) had a disorder that required immediate attention (category 4). Of these 4 patients, 2 (50%) had extensive pulmonary embolism. The majority of findings were in the lungs (63%) and abdomen (22%). The smoking history was as follows: 41% never smoked (NS), 41% former smokers (FS), and 18% current smokers (CS). The indication for follow up increased with smoking history; from 15% in NS, 18% in FS, and 31% in CS (p<0.05). Among all centers, the prevalence of non-cardiac findings ranged from 2.9% to 50%.

Twenty per cent of patients who undergo MSCT for suspected coronary artery disease, have non-cardiac findings that require further management. The majority of abnormalities involve the lung and current smokers are at higher risk of needing follow up studies. Since most research in this area has focused on patients at high risk for lung cancer, additional studies are required to determine the clinical consequences of these findings in this group of patients. A small but significant number of patients have potentially life threatening disorders

Multiple significant non cardiac abnormalities are demonstrated on MSCT Coronary Angiography; the CT reader needs to accurately detect, classify and manage these.

Gottlieb, I, Dewey, M, Miller, J, Clouse, M, Lima, J, Paul, N, Noncardiac Findings in Coronary CTA: Preliminary Results from the CorE 64 Trial.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5011990.html