Incidental Findings on Large-Field-of-View Cone Beam Computed Tomography Scans: Prevalence, Anatomical Distribution and Predictors of Clinical Relevance in a Retrospective Analysis of 203 Patients.
4 affiliations
- 1Department of Oral and Maxillofacial Surgery, Werner Forßmann Krankenhaus, Rudolph-Breitscheid-Str. 100, 16225 Eberswalde, Germany.
- 2Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
- 3Department of Periodontology, Oral Medicine and Oral Surgery, Charité-Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany.
- 4Center for Data Science, Eberswalde University for Sustainable Development, Schicklerstr. 5, 16225 Eberswalde, Germany.
Abstract
Objectives: This study aimed to assess the prevalence, anatomical distribution, and clinical relevance of incidental findings in large-field cone beam computed tomography (CBCT) scans and to identify patient-related predictors associated with their occurrence. Methods: We conducted a retrospective analysis of 203 patients in a single center who were undergoing CBCT (June 2020-January 2022; field of view: 11 cm × 10 cm) for routine diagnostics or preoperative planning. Findings were categorized by clinical relevance, mapped relative to the primary region of interest (ROI), and analyzed via logistic/Poisson regression for demographic/clinical associations. Results: Incidental findings occurred in 79.3% of the patients, with 89.6% outside the ROI. Dental/sinusoidal airway findings were the most common. Increasing age (OR = 1.11; p < 0.001) and reduced dentition compared to full dentition (>24 teeth vs full dentition IRR = 1.91; p < 0.001 and ≤24 teeth vs full dentition IRR = 2.17; p < 0.001) were significant predictors for relevant incidental findings. Other clinical factors showed elevated but non-significant risk estimates. CBCT indication did not predict the occurrence of incidental findings. Conclusions: Incidental findings in large-volume CBCT scans are common and frequently located outside the primary ROI. Age and reduced dentition were identified as potential predictors. While these findings may support a more individualized approach to CBCT volume selection, any expansion of the field of view must adhere to established radiation protection principles. Prospective studies are needed to further define risk-adapted imaging strategies.
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BibTeX
@article{heidepriem2026incidental,
title = {{Incidental Findings on Large-Field-of-View Cone Beam Computed Tomography Scans: Prevalence, Anatomical Distribution and Predictors of Clinical Relevance in a Retrospective Analysis of 203 Patients.}},
author = {Oliver Heidepriem and Saskia Preissner and Meikel Vesper and Susanne Nahles and Max Heiland and Sameh Attia and Kirstin Vach and Moritz Hertel},
journal = {Diagnostics (Basel, Switzerland)},
year = {2026},
month = sep,
doi = {10.3390/diagnostics16193152},
url = {https://europepmc.org/article/MED/42882307},
note = {CC BY},
}
RIS
TY - JOUR
TI - Incidental Findings on Large-Field-of-View Cone Beam Computed Tomography Scans: Prevalence, Anatomical Distribution and Predictors of Clinical Relevance in a Retrospective Analysis of 203 Patients.
AU - Oliver Heidepriem
AU - Saskia Preissner
AU - Meikel Vesper
AU - Susanne Nahles
AU - Max Heiland
AU - Sameh Attia
AU - Kirstin Vach
AU - Moritz Hertel
PY - 2026
DA - 2026/09/28
JO - Diagnostics (Basel, Switzerland)
DO - 10.3390/diagnostics16193152
UR - https://europepmc.org/article/MED/42882307
AB - Objectives: This study aimed to assess the prevalence, anatomical distribution, and clinical relevance of incidental findings in large-field cone beam computed tomography (CBCT) scans and to identify patient-related predictors associated with their occurrence. Methods: We conducted a retrospective analysis of 203 patients in a single center who were undergoing CBCT (June 2020-January 2022; field of view: 11 cm × 10 cm) for routine diagnostics or preoperative planning. Findings were categorized by clinical relevance, mapped relative to the primary region of interest (ROI), and analyzed via logistic/Poisson regression for demographic/clinical associations. Results: Incidental findings occurred in 79.3% of the patients, with 89.6% outside the ROI. Dental/sinusoidal airway findings were the most common. Increasing age (OR = 1.11; p < 0.001) and reduced dentition compared to full dentition (>24 teeth vs full dentition IRR = 1.91; p < 0.001 and ≤24 teeth vs full dentition IRR = 2.17; p < 0.001) were significant predictors for relevant incidental findings. Other clinical factors showed elevated but non-significant risk estimates. CBCT indication did not predict the occurrence of incidental findings. Conclusions: Incidental findings in large-volume CBCT scans are common and frequently located outside the primary ROI. Age and reduced dentition were identified as potential predictors. While these findings may support a more individualized approach to CBCT volume selection, any expansion of the field of view must adhere to established radiation protection principles. Prospective studies are needed to further define risk-adapted imaging strategies.
SN - 2075-4418
ER -