E2301. Every Pixel Counts: Don’t Forget the Corners of the Film!
  1. Amar Udare; Juravinski Hospital and Cancer Centre, McMaster University
  2. Minu Agarwal; Juravinski Hospital and Cancer Centre, McMaster University
  3. Ameya Kulkarni; Juravinski Hospital and Cancer Centre, McMaster University
  4. Yoan Kagoma; Juravinski Hospital and Cancer Centre, McMaster University
Imaging studies often cover more anatomy than the one in question. Incidental but important pathology can be found in these areas which can be easily overlooked. This “hidden” pathology can be related to the patient’s clinical condition (e.g., lung base mass on Magnetic Resonance Imaging [MRI] abdomen in a patient with an unknown primary), can be clinically significant but unrelated to the patient’s presentation (pulmonary embolism on Computed Tomography [CT] of the abdomen), or represent an incidental finding requiring further investigation (adnexal pathology on MRI lumbar spine, findings on scout images that are not imaged on rest of the sequences)

Educational Goals / Teaching Points
The objectives of this educational exhibit are to review radiological anatomy of areas covered in the periphery of routine imaging studies, to review of clinically relevant incidental and accessory findings in these areas, to discuss strategies to identify the ‘edge of film’ findings and to build a systematic search pattern and integrate this knowledge into routine practice to ensure that such findings are not missed.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Peripheral areas are often neglected in imaging studies. Anatomy of these “fringe” areas covered on cross section imaging (CT and MRI) of the head, neck, chest, abdomen, pelvis and chest and abdominal radiographs will be illustrated with annotated images. We will review a few common “hidden” pathologies using a case-based approach and discuss practical tips to integrate these imaging “corners” into the search pattern to avoid errors.

Developing a systematic approach to these ‘edge of the film’ findings is of importance to both the trainee and practicing radiologist. Identifying these can add more value to our reports and play a vital role in patient management.