title: Incidental findings on positron emission tomography/CT scans performed in the investigation of lung cancer.
abstract: OBJECTIVE
  This study aimed to clarify the number and cause of incidental findings detected on positron emission tomography (PET)/CT in patients undergoing investigation for presumed lung cancer.
  
  
  METHODS
  The scan reports from PET/CT studies performed for patients with lung cancer under National Institute for Clinical Evidence guidelines from January 2006 until March 2008 were retrospectively reviewed. Incidental findings were followed up by a combination of case note review, clinician feedback, colonoscopy database, histopathology and follow-up imaging.
  
  
  RESULTS
  818 patients were investigated for lung cancer in the study period. 197 incidental findings were found in 175 (21%) patients. The subsequent investigation of 108 lesions confirmed a pathological correlation in 71 (66%) cases. A second primary malignancy was found in 10 patients within the bowel (6), breast (2), tongue (1) and stomach (1). A pre-malignant lesion was confirmed in 25 cases (24 large bowel tubulovillous adenomas and a follicular thyroid lesion). A further 41 (5%) benign abnormalities were detected at multiple sites; the thyroid gland was the single most frequently affected site (14 abnormalities). There were 36 (4.4%) false-positive reported findings, including 17 in the region of the pharynx and larynx and 12 within the large bowel.
  
  
  CONCLUSIONS
  Overall, 9.2% of patients with suspected or known lung cancer having PET/CT had a confirmed incidental finding. A malignant or pre-malignant lesion was found in 1.2% and 3.0%, respectively. These were mostly located within the gastrointestinal tract. The majority of false-positive incidental findings were located in the larynx and pharynx. Uptake in these regions is unlikely to be significant in the absence of a CT morphological correlation.
authors: Northern General Hospital, Sheffield Teaching Hospital NHS Trust, Sheffield, UK. annuchopra1@hotmail.com
authors: A
authors: A
authors: Chopra
authors: A
authors: A
authors: Ford
authors: R
authors: R
authors: De Noronha
authors: S
authors: S
authors: Matthews
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D033162:Incidental Findings; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology; D008175:Lung Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D010307:Parotid Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D018570:Risk Assessment; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18