Incidentalomas, SPEW, and VOMIT—radiological dyspepsia?

The role of radiologist in the changing world of healthcare: a White Paper of the European Society of Radiology (ESR)

“…We devote time and attention to training our future colleagues in communication skills, and must be supported with time and resources to fulfil this communicative function in our work [ 6 ]. We ensure that our reports are not simply lists of findings, regardless of relevance or importance, but rather are actionable and practical in contributing positively to patient care and management [ 23 ]. Ring-fencing of time for preparation and conduct of multi-disciplinary team activity is essential to ensure clear communication of often-complex information [ 6 ].…”

Value-Based Radiology: A New Focus to Optimise Impact

“…Given the constant pressure of work created by ever-increasing imaging volumes, it is all too easy to lose sight of this need for effective communication and to believe that a radiologist's job is done when we have reported findings of a study. Paying attention to the content, style, standards, and clinical relevance of the reports that are generated [10][11][12] to ensure the full importance of those reports is clearly understood by the referrer and using technological tools effectively to communicate unexpected, urgent, or critical findings can add value beyond report generation itself. Using multidisciplinary team participation to ensure that radiologic findings and options are fully considered in decisionmaking is one of the most important value creators available to radiologists.…”

Scans propagating exponential workload (SPEW)

“…Incidental findings should be reported in context, with an attempt to offer guidance as to their significance. Discussion between the clinician and the radiologist should balance the potential to diagnose a pathological process against unnecessary further investigations and treatment which increase patient anxiety and health‐care costs 6,8 . As imaging technologies become more advanced, they will bring a flurry of incidental findings.…”

“…In particular, the finding of thymic remnants or hyperplasia in patients with a known tumour presents a particularly challenging diagnostic task. SPEW (scans propagating exponential workload) is an acronym that describes how incidental radiological findings can lead to a cascade of investigations 6 . The optimal strategy for further evaluation of unexpected findings is controversial.…”

“…Discussion between the clinician and the radiologist should balance the potential to diagnose a pathological process against unnecessary further investigations and treatment which increase patient anxi-ety and health-care costs. 6,8 As imaging technologies become more advanced, they will bring a flurry of incidental findings. It follows that the recognition and reporting of benign entities such as thymic remnants will become increasingly important to avoid misdiagnosis as a pathological mass.…”