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Approach to Management of Incidental Splenic Lesions: Summary of 2013 ACR Consensus Statement
Siva P. Raman, MD
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KEY FACTS

  • Terminology

    • Imaging Features

      • 2017 ACR Management System

        TERMINOLOGY

        • Definitions

          • "Incidental" splenic abnormalities are those discovered unrelated to original purpose of examination
          • Incidental splenic lesions can pose diagnostic dilemma, as imaging characteristics of both benign and malignant splenic lesions are nonspecific and can overlap
        • ACR Recommendations 2013

          • Incidental findings committee provided recommendations for management of incidentally discovered splenic masses using clinical history, prior imaging exam data, and imaging findings
          • Recommendations based on expert opinion and published evidence
          • Since vast majority of splenic lesions are benign and demonstrate relatively similar imaging features on both CT and MR, goal is to risk stratify and identify those lesions that require further work-up (rather than necessarily provide specific diagnosis)

        IMAGING ANATOMY

        • Common Benign Splenic Lesions

          • Common Malignant Splenic Lesions

            CLINICAL IMPLICATIONS

            • Major Principles of 2013 ACR Management Algorithm

              • Summary of 2013 ACR Management Algorithm

                Selected References

                1. Wei PK et al: Incidental splenic findings on cross-sectional imaging. Radiol Clin North Am. 59(4):603-16, 2021
                2. 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
                Related Anatomy
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                References
                Tables

                Tables

                KEY FACTS

                • Terminology

                  • Imaging Features

                    • 2017 ACR Management System

                      TERMINOLOGY

                      • Definitions

                        • "Incidental" splenic abnormalities are those discovered unrelated to original purpose of examination
                        • Incidental splenic lesions can pose diagnostic dilemma, as imaging characteristics of both benign and malignant splenic lesions are nonspecific and can overlap
                      • ACR Recommendations 2013

                        • Incidental findings committee provided recommendations for management of incidentally discovered splenic masses using clinical history, prior imaging exam data, and imaging findings
                        • Recommendations based on expert opinion and published evidence
                        • Since vast majority of splenic lesions are benign and demonstrate relatively similar imaging features on both CT and MR, goal is to risk stratify and identify those lesions that require further work-up (rather than necessarily provide specific diagnosis)

                      IMAGING ANATOMY

                      • Common Benign Splenic Lesions

                        • Common Malignant Splenic Lesions

                          CLINICAL IMPLICATIONS

                          • Major Principles of 2013 ACR Management Algorithm

                            • Summary of 2013 ACR Management Algorithm

                              Selected References

                              1. Wei PK et al: Incidental splenic findings on cross-sectional imaging. Radiol Clin North Am. 59(4):603-16, 2021
                              2. 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