But the scans also reveal the finest details of structures near the heart -- including the lungs, aorta, liver, pancreas and the structures and spaces that surround them. And that level of detail is only increasing as CT scanners become more powerful.

Patel and her colleagues looked at images taken with U-M's 16-slice multidetector CT scanners. But in the last year, U-M and other major centers have acquired even more powerful 64-slice CT scanners that can image the entire chest in just a few seconds, allowing even the fast-moving heart muscle and arteries to be seen clearly.

The simultaneous rapid increases in the precision and utilization of CTCA, says Patel's co-author Ella Kazerooni, M.D., makes it important to study the rate at which non-heart problems are found. Kazerooni, a professor of radiology and chief of thoracic radiology at U-M, notes that a smaller study by Johns Hopkins researchers showed that 16 percent of 75 chest pain and heart disease patients had major non-cardiac findings on their CTCA scans. The new U-M results are from a larger group of patients imaged for any reason.

Radiologists have long known that medical images taken for one reason may reveal entirely unrelated problems or suspicious areas. These "incidentalomas," as they're known, can pose serious questions of whether or not to perform a biopsy or other tests. But the rise in CTCA use by non-radiologists has raised concern that untrained eyes may miss problems outside the heart.

Patel and U-M radiologist Naama Bogot, M.D., who read all the scans, found some sort of non-heart abnormality in 61 percent of the patients. Many of these were judged insignificant. But in the 43 patients who had significant or potentially
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
16-May-2005