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

Research output: Contribution to journalArticlepeer-review


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 languageEnglish (US)
Pages (from-to)1429-1437
Number of pages9
JournalJournal of the American College of Radiology
Issue number11
StatePublished - Nov 2017


  • 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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