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

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jacr.2017.07.018 Byline: Richard M. Gore (a), Perry J. Pickhardt (b), Koenraad J. Mortele (c), Elliot K. Fishman (d), Jeanne M. Horowitz (e), Claus J. Fimmel (f), Mark S. Talamonti (g), Lincoln L. Berland (h), Pari V. Pandharipande (i) 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. Article Note: (footnote) 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.