Management of Incidental Adnexal Findings on CT and MRI: A White Paper of the ACR Incidental Findings Committee

Maitray D Patel; Susan M Ascher; Mindy M Horrow; Perry J Pickhardt; Liina Poder; Mindy Goldman; Lincoln L Berland; Pari V Pandharipande; Katherine E Maturen

doi:10.1016/j.jacr.2019.10.008

Management of Incidental Adnexal Findings on CT and MRI: A White Paper of the ACR Incidental Findings Committee

J Am Coll Radiol. 2020 Feb;17(2):248-254. doi: 10.1016/j.jacr.2019.10.008. Epub 2019 Nov 30.

Authors

Maitray D Patel¹, Susan M Ascher², Mindy M Horrow³, Perry J Pickhardt⁴, Liina Poder⁵, Mindy Goldman⁶, Lincoln L Berland⁷, Pari V Pandharipande⁸, Katherine E Maturen⁹

Affiliations

¹ Department of Radiology, Mayo Clinic Alix School of Medicine, Phoenix, Arizona. Electronic address: patel.maitray@mayo.edu.
² Department of Radiology, Georgetown University Medical Center, Washington, DC.
³ Department of Radiology, Albert Einstein Medical Center, Philadelphia, Pennsylvania.
⁴ Department of Radiology, University of Wisconsin School of Medicine, Madison, Wisconsin.
⁵ Department of Radiology, University of California San Francisco, San Francisco, California.
⁶ Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, California.
⁷ Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama.
⁸ Department of Radiology, Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts.
⁹ Department of Radiology, University of Michigan Medical School, Ann Arbor, Michigan; Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan.

PMID: 31790673
DOI: 10.1016/j.jacr.2019.10.008

Abstract

The ACR Incidental Findings Committee (IFC) presents recommendations for managing adnexal masses incidentally detected on CT and MRI. These recommendations represent an update of those provided in our previous JACR 2013 white paper. The Adnexal Subcommittee, which included six radiologists with subspecialty expertise in abdominal imaging or ultrasound and one gynecologist, developed this algorithm. The recommendations draw from published evidence and expert opinion and were finalized by iterative consensus. Algorithm branches successively categorize adnexal masses based on patient characteristics (eg, pre- versus postmenopausal) and imaging features. They terminate with a management recommendation. The algorithm addresses most, but not all, pathologies and clinical scenarios. Our goal is to improve quality of care by providing guidance on how to manage incidentally detected adnexal masses.

Keywords: Adnexal cyst; CT; MRI; incidental findings; ovarian cyst.

MeSH terms

Abdomen
Adnexal Diseases* / diagnostic imaging
Algorithms
Female
Humans
Incidental Findings*
Magnetic Resonance Imaging
Tomography, X-Ray Computed