Developing Algorithm-Based Recommendations in the ACR: Defining a New Process
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Incidental Findings
Explore general guidance on managing incidentally discovered masses.
An incidental finding refers to a lesion or abnormality discovered during imaging tests (such as CT or MRI) performed for an unrelated reason. The rise in use of cross-sectional imaging over recent decades has led to a significant increase in incidental findings. While many incidental findings are unlikely to pose risks to one’s health, detecting important conditions early, when patients are asymptomatic, may present opportunities for better patient outcomes and care. Furthermore, when guidance is not available on effective clinical management, there is also potential for over-testing and over-treatment of incidental findings associated with very low risk.
To address the need for guidance on the management of incidental findings, ACR has implemented an evidence-based process for developing algorithm-based recommendations. The process, outlined in Developing Algorithm-Based Recommendations in the American College of Radiology: Defining a New Process, ensures transparency and multidisciplinary input.
What’s New in Incidental Findings
From the November 2025 issue of JACR:
Management of Incidentally Discovered Pineal Cyst on CT and MRI: Recommendations from the ACR Incidental Findings Committee
Each guidance document defines the relevant patient population for which the recommendations apply and provides context for interpretation of the recommendations.
You can explore all Incidental Findings content on the ACR® Guidance App.
Incidental Findings Publications
The ACR Incidental Findings publications include important considerations for specific patient populations that should be taken into account prior to application.
Topics Under Development
- Fatty liver disease
- Parathyroid lesion
- Pediatric pituitary gland
- Adrenal mass (revision)
© 2025 American College of Radiology (ACR). Incidental Findings are developed by the ACR. This content may be used for internal circulation within institutions. For permission of published Incidental Findings content, visit JACR®. Additional permissions may be requested via permission request form. Any other inquiries related to the use of this content should be sent to IF@acr.org.