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Approach to Incidental Lymph Nodes on CT/MR: Summary of 2013 ACR Consensus Statement
Siva P. Raman, MD
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KEY FACTS

  • Terminology

    • Imaging Features of Normal and Abnormal Lymph Nodes

      • 2013 ACR Management System

        TERMINOLOGY

        • Definitions

          • "Incidental" lymph nodes are those discovered in patients who are undergoing imaging for unrelated reasons
          • Lymph nodes are commonly visualized on every cross-sectional imaging exam and are overwhelmingly benign, although radiologist must play role in risk stratifying which lymph nodes require further work-up
        • ACR Recommendations 2013

          • Incidental findings committee provided recommendations for management of lymph nodes encountered on imaging exams using clinical history, prior imaging exam data, and imaging findings
          • Recommendations based on expert opinion and published evidence
          • Goal is to risk stratify and identify those lymph nodes that require further work-up using combination of imaging characteristics, clinical history, patient risk factors, and prior imaging

        CLINICAL IMPLICATIONS

        • Imaging Features of Normal and Abnormal Lymph Nodes

          • Summary of 2013 ACR Management Algorithm

            • Management Options

              Selected References

              1. Heller MT et al: Managing incidental findings on abdominal and pelvic CT and MRI, part 3: white paper of the ACR Incidental Findings Committee II on splenic and nodal findings. J Am Coll Radiol. 10(11):833-9, 2013
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              KEY FACTS

              • Terminology

                • Imaging Features of Normal and Abnormal Lymph Nodes

                  • 2013 ACR Management System

                    TERMINOLOGY

                    • Definitions

                      • "Incidental" lymph nodes are those discovered in patients who are undergoing imaging for unrelated reasons
                      • Lymph nodes are commonly visualized on every cross-sectional imaging exam and are overwhelmingly benign, although radiologist must play role in risk stratifying which lymph nodes require further work-up
                    • ACR Recommendations 2013

                      • Incidental findings committee provided recommendations for management of lymph nodes encountered on imaging exams using clinical history, prior imaging exam data, and imaging findings
                      • Recommendations based on expert opinion and published evidence
                      • Goal is to risk stratify and identify those lymph nodes that require further work-up using combination of imaging characteristics, clinical history, patient risk factors, and prior imaging

                    CLINICAL IMPLICATIONS

                    • Imaging Features of Normal and Abnormal Lymph Nodes

                      • Summary of 2013 ACR Management Algorithm

                        • Management Options

                          Selected References

                          1. Heller MT et al: Managing incidental findings on abdominal and pelvic CT and MRI, part 3: white paper of the ACR Incidental Findings Committee II on splenic and nodal findings. J Am Coll Radiol. 10(11):833-9, 2013