Response to: Extravascular incidental findings at multislice CT angiography of the abdominal aorta and lower extremity arteries

Excerpt

In their recent article “Extravascular incidental findings at multislice CT angiography of the abdominal aorta and lower extremity arteries: a retrospective review study”, by Iezzi et al. [1], the authors stated that “to the best of our knowledge, there have been no published work regarding the evaluation of extravascular incidental findings on CT angiography” and that “the aim of this retrospective study was to evaluate the frequency and clinical importance of extravascular incidental findings on routine CT angiography of abdominal aorta or lower extremity arteries.” The authors then reported that among their 605 patients, of whom 373 had a standard of reference, a total of 35 malignancies were detected in 20 patients (20/423, 4.7%), and that in 15 of these patients the malignancy was not known until after the CT angiography was performed. Tables were provided for both all the benign incidental extravascular findings, as well as for the clinically relevant incidental extravascular findings detected on axial CT angiography images and then subsequently confirmed. The authors concluded that “one of the intriguing features of CT angiography… is its ability to detect extravascular lesions… because the whole abdomen, pelvis, and lower lung fields are imaged, as opposed to just the aorta and its branches” and that “a careful observation of cross-sectional images, even if ‘time consuming’, is mandatory not only to assess vascular findings but also to avoid a misdiagnosis of clinical[ly] relevant findings” [1]. …