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Radiology reporting of adrenal incidentalomas - who requires further testing?
[adrenal incidentaloma]
Adrenal
incidentalomas
(
AIs
)
are
common
and
guidelines
recommend
testing
to
exclude
functioning
lesions
and
malignancy
.
Their
increasing
prevalence
results
in
several
investigations
that
are
usually
conducted
in
the
endocrinology
clinic
.
In
2011
,
we
audited
the
prevalence
and
management
of
AIs
identified
on
computed
tomography
(
CT
)
imaging
of
abdomen
over
1
calendar
month
.
Consequently
,
a
decision
pathway
for
adrenal
lesions
was
introduced
in
the
radiology
department
of
the
Royal
Free
London
Hospital
.
One
year
later
,
we
re
-audited
the
local
practice
.
In
total
,
690
CT
scans
were
reviewed
in
2011
compared
with
1
,
264
in
2012
.
In
2011
,
17
(
2
.
46
%
)
patients
with
AIs
were
identified
,
and
26
(
2
.
01
%
)
in
2012
.
Of
those
,
1
.
01
%
in
2011
and
0
.
95
%
in
2012
had
newly
identified
AIs
.
Only
a
few
patients
had
been
tested
to
exclude
a
functional
lesion
and
there
was
inconsistent
terminology
in
reporting
adrenal
lesions
.
Therefore
,
we
support
comprehensive
reporting
of
AIs
and
a
selective
testing
strategy
.
