LAUSR

We greatly appreciate Drs. Lee and Delaney’s thoughtful comments regarding our article ‘‘Prevalence and Variability in Reporting of Clinically Actionable Incidental Findings on Attenuation-Correction CT Scans in A Veteran Population’’. The primary finding from our project was that clinically significant incidental findings on CTACs are common, and there is considerable interobserver disagreement between cardiology-trained and radiology-trained physicians in identifying them, especially for pulmonary nodules. We completely agree that this discordance represents an important gap in our current practice and warrants initiatives to assure adequate training requirements and reporting standards for interpreting CTACs. This is underscored by other studies demonstrating adverse prognosis amongst patients with major extracardiac findings on CTAC, further highlighting the need for accurate identification. Consistent with this, we implemented radiology interpretation of all CTACs in our center and believe this practice could be adopted more broadly in settings where primary cardiology readers lack experience or training in chest CT interpretation.