title: Incidental findings in emergency imaging: frequency, recommendations, and compliance with consensus guidelines.
abstract: The purpose of this study was to evaluate the frequency of incidental findings (IFs) in emergency department (ED) imaging reports and evaluate the adherence of imaging recommendations to consensus societal guidelines for IFs. A retrospective review of consecutive ED computed tomography (CT) and ultrasonography (US) reports from two university-affiliated EDs over a 2-month period was performed. Each imaging report was reviewed in its entirety, and incidental findings were documented along with recommendations for additional imaging. Imaging recommendations were compared to published societal guidelines from the American College of Radiology (ACR) and Fleischner Society. Three thousand one hundred thirty-one total cases consisting of 1967 CTs and 1164 US contained 514 incidental findings (16.4 %), with 329 CT IFs (64 %) and 185 US IFs (36 %). The ovary was the most common organ for an IF (n = 214, 42 %). Of all IFs, 347 (67.5 %) recommendations were concordant with societal guidelines and 167 (32.5 %) were discordant. 39.8 % of CT recommendations were discordant, while 19.5 % of US recommendations were discordant (p < 0.0001). Incidental findings are commonly encountered in the emergent setting. Variable adherence to societal guidelines is noted. Targeted radiologist education and technological solutions may decrease rates of discordance.
authors: Division of Emergency Radiology, Department of Radiology and Imaging Sciences, Emory University School of Medicine, 550 Peachtree Road, Atlanta, GA, 30308, USA. tarekhannamd@gmail.com.
authors: Tarek N
authors: TN
authors: Hanna
authors: Division of Emergency Radiology, Department of Radiology and Imaging Sciences, Emory University School of Medicine, 550 Peachtree Road, Atlanta, GA, 30308, USA.
authors: Haris
authors: H
authors: Shekhani
authors: Division of Emergency Radiology, Department of Radiology and Imaging Sciences, Emory University School of Medicine, 550 Peachtree Road, Atlanta, GA, 30308, USA.
authors: Matthew E
authors: ME
authors: Zygmont
authors: Emory University School of Medicine, Atlanta, GA, USA.
authors: James Matthew
authors: JM
authors: Kerchberger
authors: Division of Emergency Radiology, Department of Radiology and Imaging Sciences, Emory University School of Medicine, 550 Peachtree Road, Atlanta, GA, 30308, USA.
authors: Jamlik-Omari
authors: JO
authors: Johnson
mesh_terms: D003625:Data Collection; D004632:Emergency Medical Services; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012955:Societies, Medical
keywords: American College of Radiology Appropriateness Criteria; Emergency; Incidental findings; Radiology