Hindawi Publishing Corporation Case Reports in Medicine Volume 2013, Article ID 760543, 5 pages http://dx.doi.org/10.1155/2013/760543 Case Report Missed Lung Cancers on the Scout View: Do We Look Every Time? Sarfraz Ahmed Nazir, 1 Rachel Benamore, 2 and Fergus Gleeson 2 1 Department of Radiology, Horton Hospital, Oxford University Hospitals NHS Trust, Oxford OX16 9AL, UK 2 Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford OX3 7LE, UK Correspondence should be addressed to Sarfraz Ahmed Nazir; sarfraznazir@doctors.org.uk Received 8 September 2013; Accepted 10 December 2013 Academic Editor: Martin G. Mack Copyright © 2013 Sarfraz Ahmed Nazir et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Scout views are digital radiographs obtained to aid planning of the subsequent computed tomography (CT) examination. Review of these scout views may provide additional information not demonstrated on the axial images, but such reviews may not necessarily be performed routinely, especially in the context of abdominopelvic CT studies. We illustrate the value of the scout images by presenting a series of representative cases of missed pulmonary neoplasms in fve patients who originally underwent such examinations. 1. Introduction Te “scout” view is an obligatory part of performing com- puted tomography (CT). It is synonymously known as a scanogram, topogram, localiser, scan projection radiograph, surview, or pilot scan. Tese images are usually obtained with the patient in the supine position but can also be generated in the prone, oblique, or decubitus orientation. Tey are projectional overviews generally used as reference images for acquiring an axial CT series. Abdominopelvic CT examina- tions frequently include the lower chest on the “scout” view, but the most cranial axial CT sections usually start lower than the most cranial portion of the “scout,” potentially leaving lesions if present on the uppermost part of the “scout” not included on the axial sections. As the “scout” views are not of primary interest to the reporting radiologist, they may not be reviewed during reporting on picture archiving and communications systems (PACS) workstations, potentially resulting in a failure to detect abnormalities not included on the axial sections. We present a series of 5 cases that we have encountered in our practice illustrating the absolute necessity to review the scout images when reporting abdominopelvic CT, as summarised in Table 1. 2. Case 1 An 88-year-old patient with a prior history of caecal car- cinoma which was resected 2 years earlier presented to his family doctor with persistent macroscopic haematuria. A CT urogram (CTU) reported only marked benign prostatic hypertrophy. A plain chest radiograph performed 7 months later for a persistent cough identifed a large right lower lobe mass, measuring 10 cm in size. Review of the CTU identifed a 7 cm mass in the right lower lobe on the scout image (Figure 1), but the axial sections had started below the mass. Biopsy confrmed metastatic adenocarcinoma of the caecum. 3. Case 2 A 75-year-old gentleman with prior history of rectal can- cer in the setting of ulcerative colitis treated 3 years ear- lier with a panproctocolectomy underwent a surveillance abdominopelvic CT scan. Axial CT images of the abdomen and pelvis demonstrated no abnormality. A chest radiograph performed 7 months later for chest symptoms revealed a 2 cm lef midzone opacity. Review of the prior CT scout confrmed it to be visible. Subsequent CT of the chest and