Adrenal incidentalomas are not an uncommon finding on CT. The ACR gave recommendations on their management in 2017, which can be read in the open-access article here. The first thing that one should realize on reading the recommendations is that only adrenal nodules more than 1 cm in size in the short axis need further …
Continue reading Adrenal Incidentalomas: ACR Management Guidelines
The American College of Radiology (ACR) gave its recommendations on managing abdominal nodes on CT or MRI in 2013. These can be accessed (paid access) by clicking on the link here. The management algorithm for mediastinal nodes has also been subsequently published in 2018 (open-access), which you can read here in more detail. The important point …
Continue reading Management of Abdominal and Mediastinal Nodes: ACR Recommendations
The American College of Radiology (ACR) gave its recommendations on managing splenic incidentalomas on CT or MRI in 2013. These can be accessed (paid access) by clicking on the link here. The guidelines are, in my humble opinion, a bit conservative, but nevertheless this is what we have to follow as of now. *Cyst: …
Continue reading Management of Splenic Incidentalomas: ACR Recommendations
Incidental renal TSTCs (too small to characterize lesions) and hypodensities are a common occurrence. The ACR gave detailed guidelines on their management in 2017, which can be accessed in this open access article here. These include managing incidentalomas detected on a non-contrast CT, single phase CECT, both non-contrast and contrast CT, and for cystic or …
Continue reading Managing Renal Incidentalomas on CT: ACR Guidelines
The ACR published its recommendations for managing incidental hepatic lesions seen on CT in 2017. The salient feature of the guidelines is that subcm sized incidental liver lesions in patients without any risk factors need no further evaluation. The overall guidelines are given below; the original article is open-access and available here for further reading. …
Continue reading Management of Hepatic Incidentalomas: ACR Recommendations
It is often confusing to decide what to do about an incidental prominent to mildly enlarged paratracheal or subcarinal node seen on a chest CT. The ACR gave detailed guidelines on managing these and many other similar incidental findings on a chest CT in an open-access 2018 article. Apart from the tables below, the article …
Continue reading Managing Incidental Mediastinal Findings: ACR Recommendations
Incidental gall bladder findings, ranging from the more innocuous stones and mild CBD prominence to the more complex polyps, are common. ACR gave its recommendations on management/follow-up of incidental gall bladder and biliary findings in 2013 (you can read the closed-access article here). This was followed by a more comprehensive guideline for managing incidental gall …
The management of incidental pancreatic cysts seen on CT/MRI is based on the patient's age, imaging features such as size and communication with the main pancreatic duct, and the fact that there is a slightly higher risk of developing pancreatic cancers in some of these patients (which arise separately from the cyst). You can read …
Continue reading Incidental pancreatic cyst management: ACR recommendations
Thyroid nodule management is quite complex, with multiple criteria and recommendations coming from different sources, including recommendations for incidental nodules seen on CT. Some of the recommendations are summarized below. Society of Radiologists in Ultrasound (SRU): The recommendations of the SRU, published in Radiology 2005 here, may appear a little dated now, but are still …
Continue reading Thyroid Nodule Management: SRU, ACR, and ATA Recommendations
There are two separate criteria for incidental lung nodule management. The more commonly used one is the Fleishner criteria, last updated in 2017. Note that the Fleishner criteria can not be applied to patients with known primary cancer, patients with immunosuppression, patients <35 years age, or to lung cancer screening, and need slice thickness ≤1.5 mm. …
Continue reading Incidental Pulmonary Nodule Management: Fleishner Society and LungRADS
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