CTICasesMissed Lung Nodule on Abdominal CT Scout Topogram
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Imaging findings
The scout topogram of an abdominal CT scan showed a portion of the lungs superior to the abdominal imaging range. A lesion (lung nodule) was visible on this scout image but not included in the subsequent axial/coronal/sagittal abdominal CT images. Comparison with an older scout topogram from an outside institution demonstrated that this nodule was growing.
Key takeaways
This case emphasizes the critical importance of reviewing the scout topogram for every CT exam, regardless of the primary area of interest. Failing to examine the scout can lead to missing incidental findings, such as lung nodules, which may be significant (e.g., metastatic disease from an abdominal tumor). Regular reminders are necessary to prevent this common oversight.
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