Majority of body CT attending radiologists disagree on management of incidental findings

According to a recent study published in the November issue of the Journal of the American College of Radiology, many radiologists disagree on the management of incidental findings found on body computed tomography (CT) scans. An incidental finding is something found that is unrelated to the present illness and is discovered unintentionally.

Advances in CT resolution have improved radiologists' ability to identify small or subtle findings. In conjunction with increasing CT utilization, this has fueled 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, lead author of the study.

Researchers at Johns Hopkins University 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. Results showed that seventy percent or greater agreement on interpretation was identified for only six findings.

"It is important to note that at present, 100 percent 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," said 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," said Johnson.