Incidental extracolonic findings at CT colonography

PURPOSE: To determine the frequency of extracolonic findings at computed to mographic (CT) colonography and the effect of these findings on subsequent patient:treatment and cost. MATERIALS ANP METHODS: Conventional transverse CT colonographic scans in 26 4 consecutive patients were evaluated independently by two radiologists. Ex tracolonic findings were classified as having high, moderate, or low clinic al importance. The effect of CT findings on patient treatment was assessed with chart review. The cost of additional examinations was calculated by us ing 1999 Medicare reimbursements. RESULTS: Thirty (11%) patients had highly important extracolonic findings, which resulted in further examinations in 18 (7%) patients, including ultra sonography in 10, CT in 13, and intravenous pyelography in one. Six patient s underwent surgery because of incidentally discovered CT colonographic fin dings. Two patients with findings of moderate or low importance underwent a dditional imaging. A total of $7,324 was required for work-up for extracolo nic findings (mean of an additional $28 per examination). Three extracoloni c malignancies were overlooked at CT colonography. CONCLUSION; Additional work-up of extracolonic CT colonographic findings wa s relatively infrequent but was often worthwhile when performed for lesions classified as highly important. The evaluation of extracolonic structures at CT colonography has definite limitations with regard to solid organs but can help detect serious disease without substantially increasing the cost per patient.