Radiologists Clash on Management of Incidental Findings

According to a recent study, many radiologists disagree on the management of incidental findings found on body computed tomography (CT) imaging scans.

The study’s findings were published in the November 2011 issue of the Journal of the American College of Radiology. Recent developments in CT imaging resolution have improved radiologists’ ability to detect small or subtle findings. In combination with increasing CT utilization, this has driven the rate with which incidental findings are discovered. However, published guidelines for the management of many incidental findings are only just emerging. “The purpose of our study was to evaluate for agreement among body CT attending radiologists, both within departments and across academic institutions, for the management of a number of commonly encountered incidental findings on body CT,” said Pamela T. Johnson, MD, from Johns Hopkins University (JHU; Baltimore, MD, USA), and lead author of the study.

JHU Researchers administered a multiple-choice survey to 27 radiologists at three separate academic institutions, asking them how they would handle 12 incidental findings on body CT scans. The findings revealed that 70% or greater agreement on interpretation was identified for only six findings.

“It is important to note that at present, 100% agreement was not identified for the management of any of the 12 findings. An equally essential discovery is the lack of agreement across academic institutions and even within individual institutions for other incidental findings,” concluded Dr. Johnson. “Our findings signal the need for individual departments to develop internal guidelines so that radiologists make the best recommendations on the basis of existing evidence and provide consistent advice to referring physicians.”

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