Document Detail


Managing incidental findings on abdominal CT: white paper of the ACR incidental findings committee.
MedLine Citation:
PMID:  20889105     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
As multidetector CT has come to play a more central role in medical care and as CT image quality has improved, there has been an increase in the frequency of detecting "incidental findings," defined as findings that are unrelated to the clinical indication for the imaging examination performed. These "incidentalomas," as they are also called, often confound physicians and patients with how to manage them. Although it is known that most incidental findings are likely benign and often have little or no clinical significance, the inclination to evaluate them is often driven by physician and patient unwillingness to accept uncertainty, even given the rare possibility of an important diagnosis. The evaluation and surveillance of incidental findings have also been cited as among the causes for the increased utilization of cross-sectional imaging. Indeed, incidental findings may be serious, and hence, when and how to evaluate them are unclear. The workup of incidentalomas has varied widely by physician and region, and some standardization is desirable in light of the current need to limit costs and reduce risk to patients. Subjecting a patient with an incidentaloma to unnecessary testing and treatment can result in a potentially injurious and expensive cascade of tests and procedures. With the participation of other radiologic organizations listed herein, the ACR formed the Incidental Findings Committee to derive a practical and medically appropriate approach to managing incidental findings on CT scans of the abdomen and pelvis. The committee has used a consensus method based on repeated reviews and revisions of this document and a collective review and interpretation of relevant literature. This white paper provides guidance developed by this committee for addressing incidental findings in the kidneys, liver, adrenal glands, and pancreas.
Authors:
Lincoln L Berland; Stuart G Silverman; Richard M Gore; William W Mayo-Smith; Alec J Megibow; Judy Yee; James A Brink; Mark E Baker; Michael P Federle; W Dennis Foley; Isaac R Francis; Brian R Herts; Gary M Israel; Glenn Krinsky; Joel F Platt; William P Shuman; Andrew J Taylor
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Radiology : JACR     Volume:  7     ISSN:  1558-349X     ISO Abbreviation:  J Am Coll Radiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2011-02-02     Revised Date:  2011-03-04    
Medline Journal Info:
Nlm Unique ID:  101190326     Medline TA:  J Am Coll Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  754-73     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Radiology, University of Alabama, Birmingham, AL, USA. lberland@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adrenal Gland Neoplasms / radiography
Algorithms
Carcinoma, Renal Cell / pathology,  radiography,  surgery
Consensus
Female
Humans
Incidental Findings
Kidney Neoplasms / pathology,  radiography,  surgery
Liver Neoplasms / pathology,  radiography
Mammography / methods,  standards
Radiography, Abdominal / methods*,  standards
Risk Assessment
Tomography, X-Ray Computed / methods*,  standards
Uncertainty
Comments/Corrections
Comment In:
J Am Coll Radiol. 2011 Feb;8(2):e3-4; author reply e4   [PMID:  21292175 ]

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