The ACR gave recommendations on managing incidental pituitary lesions on CT, MRI, or PET/CT in 2018, in a paid-access article which you can refer to here. Correlation with endocrinological investigations is important in deciding further management.
If the pituitary lesion is a simple cyst
If the pituitary lesion is solid or solid-cystic
1. If the composition of the lesion cannot be ascertained with confidence, it should be considered solid.
2. Consider the possibility of a pseudolesion given the size; pseudolesions do not need further management.
If the pituitary lesion is detected on PET/CT
– Akshay Baheti, Tata Memorial Hospital
PS: All images are a copyright of the original published article.