title: Common incidental findings on MDCT: survey of radiologist recommendations for patient management.
abstract: OBJECTIVE
  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.
authors: Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA. pjohnso5@jhmi.edu
authors: Pamela T
authors: PT
authors: Johnson
authors: Karen M
authors: KM
authors: Horton
authors: Alec J
authors: AJ
authors: Megibow
authors: R Brooke
authors: RB
authors: Jeffrey
authors: Elliot K
authors: EK
authors: Fishman
mesh_terms: D000046:Academic Medical Centers; D001291:Attitude of Health Personnel; D019090:Case Management; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008499:Medical Records; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D058996:Quality Improvement; D011871:Radiology / Q000592:standards* / Q000639:trends; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D014481:United States