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Incidental Findings in Multislice CT of the Body

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Multislice CT

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

In radiology, an incidental finding (“incidentaloma”) is an incidentally discovered mass or lesion, detected by CT or other modality performed for an unrelated reason. With high-resolution cross-sectional imaging, such findings are very frequent, and an everyday challenge for radiologists.

In this chapter on incidental CT findings, the use and misuse of the term is discussed, as well as the frequency, characteristics, workup, and importance of common incidental findings in the abdomen, pelvis, and chest, with reference to guidelines for management.

Emphasis is, e.g., on controversies over management of adrenal incidentalomas, as management has changed with increasing knowledge about their clinical importance. Incidental renal tumors and complex cysts are discussed in depth, as over half of renal cancers are detected incidentally, potentially providing better prognosis. On the other hand, early detection may lead to overdiagnosis of indolent tumors with little clinical risk, also discussed in this chapter. Common incidental findings in the liver, pancreas, and reproductive organs are also discussed.

In the chest, focus is on detection, management, and clinical importance of incidental pulmonary nodules, thyroid lesions, and vascular (including coronary) calcifications, with reference to updated international guidelines.

There is also focus on technical CT factors that may limit detection of incidental findings, on reasons for not reporting incidental findings, and on patients’ opinions of incidental findings.

In conclusion, this chapter may deepen the understanding of incidental findings, and aid in the delicate task for the radiologist to balance benefits and risks when reporting such findings and recommending certain actions.

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Acknowledgement The author is grateful for constructive review of parts of the manuscript provided by radiology colleagues Mats Andersson, Kjell Geterud, Åse Johnsson, Henrik Leonhardt, and Fredrik Thorén, all at the Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden.

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  1. Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden

    Mikael Hellström MD

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  1. Mikael Hellström MD
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Correspondence to Mikael Hellström MD .

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Editors and Affiliations

  1. Department of Radiology, Universitätsklinikum Tübingen, Tübingen, Baden-Württemberg, Germany

    Konstantin Nikolaou

  2. Department of Diagnostic and Interventional Radiology, University of Freiburg, Freiburg, Germany

    Fabian Bamberg

  3. Department of Surgical and Medical Sciences and Translational Medicine, “Sapienza” – University of Rome, Rome, Italy

    Andrea Laghi

  4. Department of Radiology, Duke University School of Medicine, Durham, NC, USA

    Geoffrey D. Rubin

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Hellström, M. (2018). Incidental Findings in Multislice CT of the Body. In: Nikolaou, K., Bamberg, F., Laghi, A., Rubin, G.D. (eds) Multislice CT. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2018_186

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  • DOI: https://doi.org/10.1007/174_2018_186

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