Yukichi Tanahashi MD, Presenter: Nothing to Disclose

Satoshi Goshima MD, PhD, Abstract Co-Author: Nothing to Disclose

Hiroshi Kondo MD, Abstract Co-Author: Nothing to Disclose

Yoshifumi Noda MD, Abstract Co-Author: Nothing to Disclose

Nobuyuki Kawai MD, Abstract Co-Author: Nothing to Disclose

Hiroshi Kawada MD, Abstract Co-Author: Nothing to Disclose

Haruo Watanabe MD, Abstract Co-Author: Nothing to Disclose

Kota Sakurai, Abstract Co-Author: Nothing to Disclose

Masayuki Kanematsu MD, Abstract Co-Author: Nothing to Disclose

To evaluate the diagnostic performance of added venous phase for the detection and characterization of incidentaloma in patients with aortic aneurysm.

IRB approval and written informed consent was obtained. Consecutive 243 patients (209 men, 34 women; mean age, 75.6 years) underwent whole-body contrast-enhanced CT in arterial- and venous- phase, following unenhanced image, for the assessment of aortic aneurysm. Two observers independently and randomly reviewed images in two separate image set; 1st, unenhanced and arterial phase images, and 2nd, unenhanced, arterial-, and venous-phase images, for the evaluation of incidentaloma. Incidentalomas were scored by a five-point rating scale for the confidence level of malignancy probability. Sensitivity, specificity and areas under the receiver operating characteristic curve (AUC) for the detection of visceral malignant lesion between two image sets were evaluated.

Diagnosis of visceral malignant tumors in 15 patients were established pathologically (n = 10) and diagnostic imaging (n = 14). The sensitivity and specificity for the detection of visceral malignant tumor were significantly higher in 2nd image set (80% and 94%) than those in 1st image set (60% and 77%) in observers overall. AUCs for Observer 1 and 2 were significantly higher in 2nd image set (0.93 and 0.95) than in 1st image set (0.83 and 0.81) (P = 0.03 and 0.01). 

Diagnostic performance of incidental visceral malignancy was significantly improved by adding venous-phase to whole-body CT angiography.

The prevalence rate of malignancy in the patients with aortic aneurysms was higher because they are commonly at an old age. Our result demonstrated the additional value of venous-phase to whole-body CT angiography for the detection and characterization of incidentaloma. This information might be beneficial for the assessment of these patients.

Tanahashi, Y, Goshima, S, Kondo, H, Noda, Y, Kawai, N, Kawada, H, Watanabe, H, Sakurai, K, Kanematsu, M, Additional Value of Venous Phase to Whole-body CT Angiography in Patients with Aortic Aneurysm.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013294.html