Management of Incidental Liver Lesions on CT: A White Paper of the ACR Incidental Findings Committee

Richard M. Gore; Perry J. Pickhardt; Koenraad J. Mortele; Elliot K. Fishman; Jeanne M. Horowitz; Claus J. Fimmel; Mark S. Talamonti; Lincoln L. Berland; Pari V. Pandharipande

doi:10.1016/j.jacr.2017.07.018

Management of Incidental Liver Lesions on CT: A White Paper of the ACR Incidental Findings Committee

Richard M. Gore, Perry J. Pickhardt, Koenraad J. Mortele, Elliot K. Fishman, Jeanne M. Horowitz, Claus J. Fimmel, Mark S. Talamonti, Lincoln L. Berland, Pari V. Pandharipande

School of Medicine

Research output: Contribution to journal › Article › peer-review

33 Scopus citations

Abstract

The ACR Committee on Incidental Findings presents recommendations for managing liver lesions that are incidentally detected on CT. These recommendations represent an update from the liver component of the ACR 2010 white paper on managing incidental findings in the pancreas, adrenal glands, kidneys, and liver. The Liver Subcommittee—which included five abdominal radiologists, one hepatologist, and one hepatobiliary surgeon—developed this algorithm. The recommendations draw from published evidence and expert opinion and were finalized by informal iterative consensus. Algorithm branches categorize liver lesions on the basis of patient characteristics and imaging features. They terminate with an assessment of benignity or a specific follow-up recommendation. The algorithm addresses most, but not all, pathologies and clinical scenarios. The goal is to improve the quality of care by providing guidance on how to manage incidentally detected liver lesions.

Original language	English (US)
Pages (from-to)	1429-1437
Number of pages	9
Journal	Journal of the American College of Radiology
Volume	14
Issue number	11
DOIs	https://doi.org/10.1016/j.jacr.2017.07.018
State	Published - Nov 2017

Keywords

Incidental finding
focal nodular hyperplasia
hemangioma
hepatic cyst
hepatic metastasis
hepatocellular carcinoma

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging

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10.1016/j.jacr.2017.07.018

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title = "Management of Incidental Liver Lesions on CT: A White Paper of the ACR Incidental Findings Committee",

abstract = "The ACR Committee on Incidental Findings presents recommendations for managing liver lesions that are incidentally detected on CT. These recommendations represent an update from the liver component of the ACR 2010 white paper on managing incidental findings in the pancreas, adrenal glands, kidneys, and liver. The Liver Subcommittee—which included five abdominal radiologists, one hepatologist, and one hepatobiliary surgeon—developed this algorithm. The recommendations draw from published evidence and expert opinion and were finalized by informal iterative consensus. Algorithm branches categorize liver lesions on the basis of patient characteristics and imaging features. They terminate with an assessment of benignity or a specific follow-up recommendation. The algorithm addresses most, but not all, pathologies and clinical scenarios. The goal is to improve the quality of care by providing guidance on how to manage incidentally detected liver lesions.",

keywords = "Incidental finding, focal nodular hyperplasia, hemangioma, hepatic cyst, hepatic metastasis, hepatocellular carcinoma",

author = "Gore, {Richard M.} and Pickhardt, {Perry J.} and Mortele, {Koenraad J.} and Fishman, {Elliot K.} and Horowitz, {Jeanne M.} and Fimmel, {Claus J.} and Talamonti, {Mark S.} and Berland, {Lincoln L.} and Pandharipande, {Pari V.}",

note = "Funding Information: Dr Pickhardt is a cofounder of VirtuoCTC, has received personal fees from Check-Cap and Bracco, and is a shareholder in Cellectar, Elucent, and SHINE, outside the submitted work. Dr Berland has received personal fees from Nuance Communications, outside the submitted work. Dr Pandharipande has received a research grant from the Medical Imaging and Technology Alliance, outside the submitted work. All other authors have no conflicts of interest related to the material discussed in this article. Publisher Copyright: {\textcopyright} 2017 American College of Radiology",

year = "2017",

month = nov,

doi = "10.1016/j.jacr.2017.07.018",

language = "English (US)",

volume = "14",

pages = "1429--1437",

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AU - Fimmel, Claus J.

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AU - Berland, Lincoln L.

AU - Pandharipande, Pari V.

N1 - Funding Information: Dr Pickhardt is a cofounder of VirtuoCTC, has received personal fees from Check-Cap and Bracco, and is a shareholder in Cellectar, Elucent, and SHINE, outside the submitted work. Dr Berland has received personal fees from Nuance Communications, outside the submitted work. Dr Pandharipande has received a research grant from the Medical Imaging and Technology Alliance, outside the submitted work. All other authors have no conflicts of interest related to the material discussed in this article. Publisher Copyright: © 2017 American College of Radiology

PY - 2017/11

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N2 - The ACR Committee on Incidental Findings presents recommendations for managing liver lesions that are incidentally detected on CT. These recommendations represent an update from the liver component of the ACR 2010 white paper on managing incidental findings in the pancreas, adrenal glands, kidneys, and liver. The Liver Subcommittee—which included five abdominal radiologists, one hepatologist, and one hepatobiliary surgeon—developed this algorithm. The recommendations draw from published evidence and expert opinion and were finalized by informal iterative consensus. Algorithm branches categorize liver lesions on the basis of patient characteristics and imaging features. They terminate with an assessment of benignity or a specific follow-up recommendation. The algorithm addresses most, but not all, pathologies and clinical scenarios. The goal is to improve the quality of care by providing guidance on how to manage incidentally detected liver lesions.

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Management of Incidental Liver Lesions on CT: A White Paper of the ACR Incidental Findings Committee

Abstract

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