期刊
JOURNAL OF THE AMERICAN COLLEGE OF RADIOLOGY
卷 8, 期 11, 页码 762-767出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacr.2011.05.012
关键词
Computed tomography; incidental findings; practice guidelines; incidentalomas
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.
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