Common incidental findings on MDCT: Survey of radiologist recommendations for patient management

Pamela T. Johnson, Karen M. Horton, Alec J. Megibow, R. Brooke Jeffrey, Elliot K. Fishman

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


Purpose: The aim of this study was to evaluate for agreement with respect to how radiologists report incidental findings encountered on CT. Methods: A multiple-choice survey was designed to query radiologists about how they handle 12 incidental findings on body CT, assuming the patient is a 45-year-old woman with no history of malignancy. Included were a 1-cm thyroid nodule, a 5-mm noncalcified lung nodule, coronary artery calcification, a 2-cm adrenal nodule, a 2-cm pancreatic cyst, a 1-cm enhancing liver lesion, a 2-cm high-density renal cyst, short-segment small bowel intussusception, a 1-cm splenic cyst, focal gallbladder wall calcification, and a 3-cm ovarian cyst in both a premenopausal woman and a postmenopausal woman. Choices ranged from "do not report" to advising interventional procedures tailored to the organ. Surveys were administered to body CT attending radiologists at 3 academic institutions. Results: Twenty-seven radiologists completed the survey. The mean experience level was 15.7 years after training. Seventy percent or greater agreement on interpretation was identified for only 6 findings: recommend ultrasound for a 1-cm thyroid nodule, recommend ultrasound for a 3-cm cyst in postmenopausal woman, follow Fleischner Society recommendations for a 5-mm lung nodule, describe only coronary calcification, and describe as likely benign both short-segment small bowel intussusception and a 1-cm splenic cyst. Conclusions: Agreement is lacking, both across institutions and within departments, for the management of 6 commonly encountered incidental findings on body CT. Individual departments should develop internal guidelines to ensure consistent recommendations based on existing evidence.

Original languageEnglish (US)
Pages (from-to)762-767
Number of pages6
JournalJournal of the American College of Radiology
Issue number11
StatePublished - Nov 2011


  • Computed tomography
  • incidental findings
  • incidentalomas
  • practice guidelines

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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