title: Radiology reporting of adrenal incidentalomas - who requires further testing?
abstract: Adrenal incidentalomas (AIs) are common and guidelines recommend testing to exclude functioning lesions and malignancy. Their increasing prevalence results in several investigations that are usually conducted in the endocrinology clinic. In 2011, we audited the prevalence and management of AIs identified on computed tomography (CT) imaging of abdomen over 1 calendar month. Consequently, a decision pathway for adrenal lesions was introduced in the radiology department of the Royal Free London Hospital. One year later, we re-audited the local practice. In total, 690 CT scans were reviewed in 2011 compared with 1,264 in 2012. In 2011, 17 (2.46%) patients with AIs were identified, and 26 (2.01%) in 2012. Of those, 1.01% in 2011 and 0.95% in 2012 had newly identified AIs. Only a few patients had been tested to exclude a functional lesion and there was inconsistent terminology in reporting adrenal lesions. Therefore, we support comprehensive reporting of AIs and a selective testing strategy.
authors.affiliation: Royal Free London NHS Foundation Trust, London, UK;
authors.forename: Fiona
authors.initials: F
authors.lastname: Paterson
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Theodoraki
authors.forename: Adaugo
authors.initials: A
authors.lastname: Amajuoyi
authors.forename: Pierre-Marc
authors.initials: PM
authors.lastname: Bouloux
authors.forename: Jody
authors.initials: J
authors.lastname: Maclachlan
authors.forename: Bernard
authors.initials: B
authors.lastname: Khoo
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003663:Decision Trees; D004704:Endocrinology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data; D009626:Terminology as Topic; D014057:Tomography, X-Ray Computed; D006113:United Kingdom / Q000453:epidemiology
keywords: Adrenal incidentaloma; audit; clinical practice; endocrinology; radiology