Reveal LINQ ICM

There is an insertable cardiac monitor (ICM) specifically a Reveal LINQ, implanted within the anterior precordial soft tissues. This is best visualized on the lateral view and poorly identified on the frontal view. The cardiothoracic ratio is normal and the lung fields are clear.

Modern PACS and reporting software can improve the search for these elusive devices especially when they are poorly appreciated on X-rays. Below are some examples to improve the detection of these devices.

Disclosure: I, Ashesh I Ranchod, have no actual or potential ethical or financial conflict of interest in relation to this device. This case is not intended to be a personal endorsement or recommendation of this product.

Align the frontal and lateral view equally, side by side, and draw a line superior and inferior to the identified device on the lateral series and continue these lines onto the frontal series. The device should be within this border zone on the frontal series as demonstrated above.

Note: the contrast has not been adjusted here!

Changing the contrast window to the reverse window may assist in identifying the device on the frontal series as demonstrated above.

In this instance, the lateral view has been made lighter and the frontal view has been adjusted to appear darker, hence the device is easily identified on the X-rays.

The zoom tool can be effectively utilized to scrutinise the precordial soft tissues to identify the device.