Alex Bibbey BS, Presenter: Nothing to Disclose

Charles A. Ritchie MD, Abstract Co-Author: Nothing to Disclose

Beau Toskich MD, Abstract Co-Author: Nothing to Disclose

Steven Kraft MD, Abstract Co-Author: Nothing to Disclose

David Cole Wymer MD, Abstract Co-Author: Nothing to Disclose

With the growing use of rubidium-82 cardiac PET/CT imaging, we wished to determine whether the number and nature of non-cardiac findings present on the attenuation correction non-contrasted CT warrant formal interpretation by a board certified radiologist.

A continuous series of 765 rubidium-82 cardiac PET/CT examinations, representing approximately one year of clinical volume at the Malcolm Randall Gainesville Florida/South Georgia Veterans Administration Hospital, affiliated with the Shands Teaching Hospital at the University of Florida, were evaluated by two radiologists for findings unrelated to cardiac perfusion. Findings that required additional management, follow-up, or potentially explained the indication for cardiac PET/CT examination, i.e. chest pain, shortness of breath, were recorded.

765 rubidum-82 cardiac PET/CT studies were evaluated, consisting of 49 females (6.4%) and 716 males (93.6%) with a mean age of 63.1 years. 269 non-cardiac findings were identified in 223 patients (29.2%), with 45 distinct findings. The ten most common findings were solitary pulmonary nodule of 3 mm or greater (42, 5.5%), lymphadenopathy of short axis 1 cm or greater  (24, 3.1%), hiatal hernia (17, 2.2%), pleural effusion (17, 2.2%), interstitial lung disease or pulmonary fibrosis (17, 2.2%), aortic aneurysm (15, 2.0%), fatty liver disease (13, 1.7%), airspace disease (12, 1.6%), multiple pulmonary nodules (11, 1.4%), and COPD or emphysema (10, 1.3%).

We observed a rate of approximately one out of three patients with significant non-cardiac findings either explaining study indications or requiring physician notification. Interpretation of cardiac PET/CT by physicians trained in thoracic and abdominal imaging is necessary to deliver quality patient care and identify conditions that would have otherwise gone unrecognized. 

Significant incidental findings on Rb-82 cardiac PET/CT are common and require interpretation by physicians trained in thoracic and abdominal imaging.

Bibbey, A, Ritchie, C, Toskich, B, Kraft, S, Wymer, D, Incidental Non-cardiac Findings on Rubidium-82 Cardiac PET/CT.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11013568.html