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Incidental Findings
Gastrointestinal
Management of Incidental Liver Lesions
Management of Incidental Liver Lesions
Siva P. Raman, MD
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KEY FACTS

  • Terminology

    • CT/MR Reporting

      • 2017 ACR Management Algorithm

        • Imaging Protocol

          TERMINOLOGY

          • Definitions

            • "Incidental" liver lesions are those discovered in patients who are undergoing imaging for unrelated reasons (in spectrum of patients who may be at either low or high risk for malignant liver lesion)
            • Vast majority of incidentally encountered liver lesions are benign (cysts, hemangiomas, etc.), although malignant lesions can rarely be encountered incidentally as well (e.g., metastasis, hepatocellular carcinoma, cholangiocarcinoma, etc.)

          • ACR Recommendations 2017

            • Revision of previous guidelines from 2010 regarding management of benign liver lesions created by panel composed of members from radiology, surgery, and hepatology
            • Takes into account number of different factors, including lesion size, attenuation, complexity, enhancement pattern, multiplicity, growth pattern, and location, along with patient risk factors
            • Algorithm provides radiologists tool to risk stratify lesions and provides recommendations regarding management
            • Recommendations based on expert opinion and published evidence

          IMAGING ANATOMY

          • Classic Imaging Appearance of Benign Lesions

            • Imaging Features Impacting Assessment

              • Imaging Protocol

                CLINICAL IMPLICATIONS

                • Patient Criteria for 2017 ACR Management Algorithm

                  • Major Principles of 2017 ACR Management Algorithm

                    • Summary of 2017 ACR Management Algorithm

                      Selected References

                      1. Abu-Yousef MM et al: Re: "management of incidental liver lesions on CT: a white paper of the ACR incidental findings committee". J Am Coll Radiol. 15(7):941, 2018
                      2. Gore RM et al: Management of incidental liver lesions on CT: a white paper of the ACR incidental findings committee. J Am Coll Radiol. 14(11):1429-37, 2017
                      Related Anatomy
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                      Related Differential Diagnoses
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                      References
                      Tables

                      Tables

                      KEY FACTS

                      • Terminology

                        • CT/MR Reporting

                          • 2017 ACR Management Algorithm

                            • Imaging Protocol

                              TERMINOLOGY

                              • Definitions

                                • "Incidental" liver lesions are those discovered in patients who are undergoing imaging for unrelated reasons (in spectrum of patients who may be at either low or high risk for malignant liver lesion)
                                • Vast majority of incidentally encountered liver lesions are benign (cysts, hemangiomas, etc.), although malignant lesions can rarely be encountered incidentally as well (e.g., metastasis, hepatocellular carcinoma, cholangiocarcinoma, etc.)

                              • ACR Recommendations 2017

                                • Revision of previous guidelines from 2010 regarding management of benign liver lesions created by panel composed of members from radiology, surgery, and hepatology
                                • Takes into account number of different factors, including lesion size, attenuation, complexity, enhancement pattern, multiplicity, growth pattern, and location, along with patient risk factors
                                • Algorithm provides radiologists tool to risk stratify lesions and provides recommendations regarding management
                                • Recommendations based on expert opinion and published evidence

                              IMAGING ANATOMY

                              • Classic Imaging Appearance of Benign Lesions

                                • Imaging Features Impacting Assessment

                                  • Imaging Protocol

                                    CLINICAL IMPLICATIONS

                                    • Patient Criteria for 2017 ACR Management Algorithm

                                      • Major Principles of 2017 ACR Management Algorithm

                                        • Summary of 2017 ACR Management Algorithm

                                          Selected References

                                          1. Abu-Yousef MM et al: Re: "management of incidental liver lesions on CT: a white paper of the ACR incidental findings committee". J Am Coll Radiol. 15(7):941, 2018
                                          2. Gore RM et al: Management of incidental liver lesions on CT: a white paper of the ACR incidental findings committee. J Am Coll Radiol. 14(11):1429-37, 2017