Ramin Javan MD, Abstract Co-Author: Nothing to Disclose

Bryan Su-Hyun Jeun MD, Presenter: Nothing to Disclose

Christopher John Roth MD, Abstract Co-Author: Nothing to Disclose

A compilation of tables and algorithms regarding incidental imaging findings was created in hopes of assisting radiologists in making more up-to-date and uniform recommendations for further management.

Incidental imaging findings are encountered daily and their management can be challenging and at times controversial. Use of decision support tools appears on the horizon in all aspects of radiology, especially as part of the Imaging 3.0 movement by the American College of Radiology (ACR). With the current focus on cost reduction in health care as well as attempts to improve quality of patient care, a unified and systematic multi-specialty approach to incidental findings seems inevitable.

An array of tables, algorithms, recommendations and figures were collected from the most recent peer-reviewed literature as well as guidelines from various societies, such as the ACR and SRU, regarding incidental imaging findings. These were categorized by body part and are listed as follows. Abdomen and pelvis: Incidentalomas in liver, pancreas, adrenal glands, and kidneys on CT, ovarian cyst on CT, ovarian and paraovarian cyst on US, gallbladder polyp on US, focal gallbladder wall calcification, renal cyst on lumbar MRI, short segment bowel intussusception, mesenteric lymph nodes and misty mesentery, T2 hypointense adnexal lesions on MRI. Thorax: Fleischner pulmonary nodule follow-up, subsolid pulmonary nodules, enlarged mediastinal lymph nodes on CT, coronary artery calcification on CT, breast nodule on CT, pulmonary nodule in abdominal CT, pulmonary nodule on cardiac CTA including small field-of-view, extracardiac incidental findings on cardiac MRI, pleural effusion on screening breast MRI. Brain and Head/Neck: Thyroid nodule on PET and on CT, carotid disease in soft tissue neck CT, parathyroid incidentaloma on thyroid ultrasound, brain fMRI incidentalomas, pituitary incidentalomas.

The ultimate goal is to use this collection as the backbone for a stand-alone or web-based all-encompassing incidentaloma decision support tool. Ideally, this tool can manually or semi-automatically be updated by creating alerts when relevant publications or guidelines become available.

Javan, R, Jeun, B, Roth, C, An All-encompassing Multi-specialty Incidentaloma Decision Support Tool for the Daily Practice of Radiology.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13016106.html