Managing Incidental Findings

Valeria Makeeva, MD; Kirsten Schofield, MS; Melissa Davis, MBA, MD; Nadja Kadom, MD


Appl Radiol. 2021;50(6):22-26. 

In This Article

Abstract and Introduction


An incidental finding, also referred to as an incidentaloma, is a mass or lesion detected on diagnostic imaging studies performed for an unrelated reason.[1] For example, a pulmonary nodule discovered on a computed tomography (CT) angiogram of the chest for a suspected pulmonary embolism is considered an incidental finding.[2]

Radiologists recognize that ensuring appropriate follow-up for incidental findings is highly important. Those that require additional action are referred to as an actionable incidental finding (AIF, Figure 1). Approximately 65% of all incidental findings are AIFs; among these, a diagnosis is confirmed in approximately 45% of patients.[3] The incidence of cancer among all incidental findings completing follow-up is 2.3–4.5%.[4,5]

Figure 1.

Terminology used for various imaging findings. Terminology has an important function in linking types of findings to means of communication by which these results should be reported. In this framework, an actionable finding is any finding that benefits from a non-routine result communication method. An actionable incidental finding (AIF) is one that benefits from non-routine result communication (bolded font) but is not a critical finding.

In this review, we discuss the nature of AIFs and how radiologists supported by information technology (IT) tools can best manage them to achieve better patient outcomes.