Classification of incidental findings

Abstract

Cross-sectional imaging, by means of CT and MR imaging, has evolved to play a major part in patient management as well for investigations on population-based cohorts. Due to continuous improvements in scanner and sequence technology, cross-sectional imaging has steadily advanced to provide excellent spatiotemporal resolution imaging, enabling the detection of complex disease processes as well as subclinical disease states (Bamberg et al. 2015). Apart from aiding to assess the target structures and sought medical issues, the increased application of cross-sectional imaging methods has resulted in an increased detection of incidental findings (IF). While some studies indicate that a high number of IFs derived from research studies result in important clinical benefits, such as earlier diagnosis to a small but significant minority of participants (Orme et al. 2010; Espinoza et al. 2014), the American College of Radiology pleads caution on the potential cascade of additional (noninvasive and invasive) investigations, anxiety and morbidity caused by the discovery of IFs (Berland et al. 2010). Hence, guidance on IF categorization and management is indispensable, yet difficult to allocate. While most population-based screening studies provide dedicated guidelines for IF management, the lack of clear-cut recommendations for IF management in the clinical setting results in high variations in practice among reporting radiologists.