Radiology reporting of adrenal incidentalomas – who requires further testing?

Paterson, Fiona; Theodoraki, Aikaterini; Amajuoyi, Adaugo; Bouloux, Pierre-Marc; Maclachlan, Jody; Khoo, Bernard

doi:10.7861/clinmedicine.14-1-16

Cited by 7 publications

(5 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar to the concept of varying thresholds for defining a test result positive in meta-analyses of diagnostic accuracy, heterogeneity is common when primary study authors use different definitions for “positive,”59 or more specifically in our case, varying thresholds for what constitutes an incidentaloma. Unfortunately, there are no universally accepted definitions or thresholds for what constitutes an incidentaloma 60. Thus, our results mirror the likely situation clinicians face when requesting imaging scans: the same radiologist is unlikely to report all images requested and thus there is likely to be heterogeneity in the reporting of incidentalomas from image to image.…”

Section: Discussionsupporting

confidence: 56%

Prevalence and outcomes of incidental imaging findings: umbrella review

O’Sullivan

Muntinga

Grigg

et al. 2018

BMJ

220

175

View full text Add to dashboard Cite

ObjectiveTo provide an overview of the evidence on prevalence and outcomes of incidental imaging findings. DeSiGNUmbrella review of systematic reviews. Data SOurceSSearches of MEDLINE, EMBASE up to August 2017; screening of references in included papers. eliGibility criteria Criteria included systematic reviews and meta-analyses of observational studies that gave a prevalence of incidental abnormalities ("incidentalomas"). An incidental imaging finding was defined as an imaging abnormality in a healthy, asymptomatic patient or an imaging abnormality in a symptomatic patient, where the abnormality was not apparently related to the patient's symptoms. Primary studies that measured the prevalence of incidentalomas in patients with a history of malignancy were also considered in sensitivity analyses. reSultS 20 systematic reviews (240 primary studies) were identified from 7098 references from the database search. Fifteen systematic reviews provided data to quantify the prevalence of incidentalomas, whereas 18 provided data to quantify the outcomes of incidentalomas (13 provided both). The prevalence of incidentalomas varied substantially between imaging tests; it was less than 5% for chest computed tomography for incidental pulmonary embolism in patients with and without cancer and whole body positron emission tomography (PET) or PET/computed tomography (for patients with and without cancer). Conversely, incidentalomas occurred in more than a third of images in cardiac magnetic resonance imaging (MRI), chest computed tomography (for incidentalomas of thorax, abdomen, spine, or heart), and computed tomography colonoscopy (for extracolonic incidentalomas). Intermediate rates occurred with MRI of the spine (22%) and brain (22%). The rate of malignancy in incidentalomas varied substantially between organs; the prevalence of malignancy was less than 5% in incidentalomas of the brain, parotid, and adrenal gland. Extra-colonic, prostatic, and colonic incidentalomas were malignant between 10% and 20% of the time, whereas renal, thyroid, and ovarian incidentalomas were malignant around a quarter of the time. Breast incidentalomas had the highest percentage of malignancy (42%, 95% confidence interval 31% to 54%). Many assessments had high between-study heterogeneity (15 of 20 metaanalyses with I 2 >50%).cONcluSiONS There is large variability across different imaging techniques both in the prevalence of incidentalomas and in the prevalence of malignancy for specific organs. This umbrella review will aid clinicians and patients weigh up the pros and cons of requesting imaging scans and will help with management decisions after an incidentaloma diagnosis. Our results can underpin the creation of guidelines to assist these decisions.

show abstract

Section: Discussionsupporting

confidence: 56%

Prevalence and outcomes of incidental imaging findings: umbrella review

O’Sullivan

Muntinga

Grigg

et al. 2018

BMJ

220

175

View full text Add to dashboard Cite

show abstract

“…Paterson et al developed a decision pathway based on size and HU to assist radiologists in determining appropriate recommendations for next steps. 54 These recommendations for referrals or additional testing were included in the report. Clinical outcomes have not yet been evaluated.…”

Section: Management Strategies For Initial Evaluation and Follow-up Of Iams: (14 Studies Systematically Reviewed)mentioning

confidence: 99%

Incidental Adrenal Masses: Adherence to Guidelines and Methods to Improve Initial Follow-Up: A Systematic Review

Feeney

Madiedo

Knapp

et al. 2022

Journal of Surgical Research

View full text Add to dashboard Cite

“…The incidence of myelolipomas seems to be rising from 0.2 % to 10 % during the last decade [ 4 ]. It is usually clinically silent [ 1 ] and considered as adrenal incidentaloma, which is defined as clinically unsuspected adrenal mass discovered on imaging studies conducted for reasons other than study of adrenal glands [ 5 ]. Symptoms tends to occur with rise in size of the lesion either due to mass effect or hemorrhage [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Unusual discovery: Incidental diagnosis of adrenal myelolipoma, initially confused with liposarcoma, following bee sting bite, resolving chronic right hypochondrial discomfort - A case report

Balagobi,

Gobishangar,

Theepan

et al. 2024

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

Radiology reporting of adrenal incidentalomas – who requires further testing?

Cited by 7 publications

References 14 publications

Prevalence and outcomes of incidental imaging findings: umbrella review

Prevalence and outcomes of incidental imaging findings: umbrella review

Incidental Adrenal Masses: Adherence to Guidelines and Methods to Improve Initial Follow-Up: A Systematic Review

Unusual discovery: Incidental diagnosis of adrenal myelolipoma, initially confused with liposarcoma, following bee sting bite, resolving chronic right hypochondrial discomfort - A case report

Contact Info

Product

Resources

About