Managing Incidental Findings on Abdominal and Pelvic CT and MRI, Part 3: White Paper of the ACR Incidental Findings Committee II on Splenic and Nodal Findings

Abstract

This white paper describes splenic and nodal incidental findings found on CT and MRI. Recommendations for management are included. This represents the third of 4 such papers from the ACR Incidental Findings Committee II, which used a consensus method based on repeated reviews and revisions and a collective review and interpretation of relevant literature. Topics include descriptions of appearances of several types of splenic lesions and, the importance of size and distribution of lymph nodes. Flowcharts are provided for reference.

Retrospective chart analysis of incidental findings detected by 18F‐fluorodeoxyglucose‐PET/CT in patients with cutaneous malignant melanoma

“…Most findings represented tumors, and required endoscopic or surgical procedures. Furthermore, the detection of unexpected benign or malignant lesions using other imaging methods, such as CT or MRI, has also been described, and the role of incidental findings using these modalities has been extensively studied . Although abnormal FDG‐PET/CT findings should be worked up, it is difficult to estimate the benefit of their detection.…”

Extraurinary Incidental Findings on CT for Hematuria: The Radiologist's Role and Downstream Cost Analysis

“…The 2010 ACR white paper for reporting of incidental findings [11] describes consensus recommendations for reporting and managing incidental findings involving the liver, kidneys, pancreas, and adrenal glands, with recommendations for additional organ systems published in 2013 [34][35][36][37]. Such consensus recommendations promise to help make patient care more consistent and optimize further testing and treatment.…”

Evidence-Based Cancer Imaging

“…In such a situation, we must resort to the next best option which is consensus-based guidelines. In 2010, the first white paper of the American College of Radiology (ACR) Incidental Findings Committee on management of incidental findings on abdominal CT was published (1), followed by additional papers focusing on specific organs (14151617). …”