Follow-up Recommendations for Incidentalomas: A One-Stop Shop for all Radiologists

It is not uncommon to come across an incidental benign-appearing or indeterminate lesion on imaging and then wonder what to do next with it. Indeed, there has been an epidemic of thyroid and adrenal nodules which we shouldn't be doing anything about, thanks to their increased pick-up on imaging. We need to balance the need …

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Managing Incidental Vascular Findings in the Abdomen: ACR Guidelines

We often come across incidental abdominal aortic ectasia or a splenic artery aneurysm while reporting a CT and wonder what to do about it. The ACR gave useful recommendations for their management in 2013, in a closed-access paper available here. Unlike other white papers, the white paper on vascular findings does not give a lot …

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Management of Incidental Pituitary Findings: ACR Recommendations

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. …

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Adrenal Incidentalomas: ACR Management Guidelines

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 …

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Management of Abdominal and Mediastinal Nodes: ACR Recommendations

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 …

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Management of Splenic Incidentalomas: 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: …

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Managing Renal Incidentalomas on CT: ACR Guidelines

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 …

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Management of Hepatic Incidentalomas: ACR Recommendations

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. …

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Managing Incidental Mediastinal Findings: 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  …

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Management of Incidental Gall Bladder Polyps and Other Findings: ACR and ESGAR Guidelines

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 …

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