title: Utility of screening computed tomography of chest, abdomen and pelvis in patients after heart transplantation.
abstract: BACKGROUND
  Malignancy is a late cause of mortality in heart transplant recipients. It is unknown if screening computed tomography scan would lead to early detection of such malignancies or serious vascular anomalies post heart transplantation.
  
  
  METHODS
  This is a single center observational study of patients undergoing surveillance computed tomography of chest, abdomen and pelvis at least 5 years after transplantation. Abnormal findings, included pulmonary nodules, lymphadenopathy and intra-thoracic and intra-abdominal masses and vascular anomalies such as abdominal aortic aneurysm. The clinical follow up of each of these major abnormal findings is summarized.
  
  
  RESULTS
  A total of 63 patients underwent computed tomography scan of chest, abdomen and pelvis at least 5 years after transplantation. Of these, 54 (86%) were male and 9 (14%) were female. Mean age was 52±9.2 years. Computed tomography revealed 1 lung cancer (squamous cell) only. Non specific pulmonary nodules were seen in 6 patients (9.5%). The most common incidental finding was abdominal aortic aneurysms (N=6 (9.5%)), which necessitated follow up computed tomography (N=5) or surgery (N=1). Mean time to detection of abdominal aortic aneurysms from transplantation was 14.6±4.2 years. Mean age at the time of detection of abdominal aortic aneurysms was 74.5±3.2 years.
  
  
  CONCLUSIONS
  Screening computed tomography scan in patients 5 years from transplantation revealed only one malignancy but lead to increased detection of abdominal aortic aneurysms. Thus the utility is low in terms of detection of malignancy. Based on this study we do not recommend routine computed tomography post heart transplantation.
authors.affiliation: Cardiology/Heart Failure and Heart Transplant Program, Loyola University Medical Center, Maywood, IL 60153, USA. dasaritarun@gmail.com
authors.forename: Tarun W
authors.initials: TW
authors.lastname: Dasari
authors.forename: Biljana
authors.initials: B
authors.lastname: Pavlovic-Surjancev
authors.forename: Linda
authors.initials: L
authors.lastname: Dusek
authors.forename: Nilamkumar
authors.initials: N
authors.lastname: Patel
authors.forename: Alain L
authors.initials: AL
authors.lastname: Heroux
mesh_terms: D000368:Aged; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology; D010388:Pelvis / Q000000981:diagnostic imaging*; D011860:Radiography, Abdominal / Q000379:methods*; D013902:Radiography, Thoracic / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000209:etiology