Marina Ulla MD, Presenter: Nothing to Disclose

Ernestina Gentile DMD, Abstract Co-Author: Nothing to Disclose

Ezequiel Levy Yeyati MD, Abstract Co-Author: Nothing to Disclose

Gabriel Cook, Abstract Co-Author: Nothing to Disclose

Sofia Bakken, Abstract Co-Author: Nothing to Disclose

Laura Frank, Abstract Co-Author: Nothing to Disclose

Ricardo D. Garcia-Monaco MD, PhD, Abstract Co-Author: Research Consultant, Siemens AG Research Consultant, BTG International Ltd

Pneumo-MDCT is a new technique being offered to patients for the presurgical assessment and characterization of esophageal and GE junction neoplasms (E-GEN). The aims of this study were to prospectively determine the frequency of extraesophago-gastric findings at Pneumo-MDCT, to classify them according to the clinical importance, relationship to E-GEN and to evaluate the consequences of these findings.

300 consecutive patients undergoing study for E-GEN were examined with Pneumo-MDCT. Two independent radiologists reviewed the CT-images for extraesophago-gastric pathology, findings were classified as either clinically important or unimportant and related or not with E-GEN. Clinically important findings were defined as those that necessitated further diagnostic studies, medical or surgical follow-up. Electronic medical records were reviewed to determine the consequences of the workup derived from Pneumo-MDCT.

In the 300 patients studied: 287 patients (95%) had a total of 780 extraesophago-gastric findings, 73 (9.3%) were clinically important findings and 707 (90.7%) were unimportant. In the clinically important findings group 38/73 (52%) were lesions not related with E-GEN and 35/73 (48%) were related with E-GEN. In the clinically unimportant findings group 707/707 (100%) were not related with E-GEN. None of the patients with clinically unimportant findings underwent further testing while all important findings required follow-up. 

Pneumo-MDCT identifies a large number of extraesophago-gastric findings. Extraesophago-gastric findings are common, mostly those not related with E-GEN. Only patients with highly clinical significant findings required further diagnostic testing. Additional studies to determine cost-effectiveness and legal implications of detecting extraesophago-gastric findings are warranted.

Beyond assessment and characterization of esophageal and GE junction neoplasms, Pneumo-MDCT identifies a large number of extraesophago-gastric findings.

Ulla, M, Gentile, E, Levy Yeyati, E, Cook, G, Bakken, S, Frank, L, Garcia-Monaco, R, Incidental Extraesophago-gastric Findings at Pneumo-MDCT.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14007132.html