Extra cardiac findings in cardiovascular MR: Why cardiologists and radiologists should read together

• Published in: The International Journal of Cardiovascular Imaging Vol. 30; no. 3; pp. 609 - 617
• Main Authors: Greulich, Simon, Backes, Maik, Schumm, Julia, Grün, Stefan, Steubing, Hannah, Sechtem, Udo, Geissler, Angela, Mahrholdt, Heiko
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.03.2014; Springer Nature B.V
• Subjects: Cardiac Imaging; Cardiology; Cardiology - methods; Cardiovascular Diseases - diagnosis; Contrast Media; Female; Gadolinium DTPA; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Imaging; Incidental Findings; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Original Paper; Physicians; Radiology; Radiology - methods; Retrospective Studies; Cardiovascular magnetic resonance; Extra cardiac findings; Joint reading; Cardiologist and radiologist collaboration
• ISSN: 1569-5794; 1573-0743; 1875-8312
• DOI: 10.1007/s10554-014-0368-1

Purpose: To assess prevalence and significance of extra cardiac findings (ECF) in clinical routine cardiovascular magnetic resonance (CMR) studies reported by cardiologists alone versus cardiologist and radiologist working together. Methods: One-thousand-seventy-four consecutive patients presenting at our institution for CMR work-up of multiple cardiovascular disease entities were enrolled retrospectively in two groups (cardiologists reading alone vs. cardiologists and radiologist reading together). Results: In 1,074 routine CMR studies a total of 357 ECF’s were identified in 235 patients yielding a prevalence of 21.9 %. Of these 357 ECF’s more than one-third were previously known. In the remaining 223 previously unknown findings 118 (52.9 %) were considered as major ECF’s (92 patients), and 105 (47.1 %) were considered as minor ECF’s (69 patients). Cardiologists reading alone reported 23 previously unknown ECF’s in 23 patients, versus 200 previously unknown ECF in 138 patients by cardiologists and radiologists working together, p  < 0.0001. Nevertheless, highly significant ECF’s with major prognostic implications, such as the initial diagnosis of malignancy in an individual with no history of cancer, are extremely rare (n = 3, 0.3 %). Cardiologists alone, as well as cardiologists and radiologists working together seem to do well with reporting of such extremely important ECF’s. Conclusions: The prevalence of all ECF’s was 21.9 %, and 14.9 % of previously unknown ECF’s, respectively. However, the prevalence of highly significant ECF’s was low. Joint reading with cardiologists and radiologists may increase the number of ECF’s detected in CMR studies, but it remains unclear if this could result in an improved long-term outcome of patients undergoing routine CMR.