Abstract
Incidental findings are common in medical imaging. There is a particularly high prevalence of incidental findings within the thorax, the most frequent being pulmonary nodules. Whilst pulmonary nodules have the potential to be malignant, the vast majority will be benign, resulting in a high number of false-positive findings. Low-resolution CT images produced during attenuation correction (AC) during single-photon emission tomography (SPECT) are essentially a by-product of the process. The high number of false-positive incidental findings detected on CTAC images causes a reporting dilemma. Early detection of cancer can be beneficial but false-positive findings and over diagnosis can be detrimental to the patient. CTAC images are not diagnostic quality and further diagnostic tests are usually necessary for definitive diagnosis to be reached. Given the high number of false-positive findings, the psychological effects and harms to the patient should be given consideration. This review recommends that caution should be taken when routine reporting of CTAC images occurs.
