ACR Members' Response to JACR White Paper on the Management of Incidental Abdominal CT Findings

Purpose: In October 2010, a white paper was published in this journal that represented a consensus of the ACR Incidental Findings Committee, including guidance for characterizing, reporting, and managing incidental findings in the liver, kidneys, adrenal glands, and pancreas. A survey was conducted of the ACR membership to determine how widely this paper had been read, how the information is being used, and how management of incidental findings may be improved. Methods: A survey consisting of 14 multiple-choice and 5 free-text responses was distributed by e-mail to 14,336 ACR physician members. The survey was open during June and July 2012 using SurveyMonkey. Topics included how the paper's recommendations had affected practice and the frequency of recommendations for additional imaging, how incidental findings are reported, the content and the form of the white paper, and the possible effects of tort reform. Results: Of the 14,336 radiologists contacted, 2,892 (20%) returned the survey; of these, 1,099 (38%) indicated that they had read the paper. Of the 1,099 radiologists who read the paper, 978 (89%) responded that the content was used in clinical practice. The white paper led 560 radiologists (51%) to recommend additional imaging less often and 33 radiologists (3%) to recommend imaging more often. Tort reform was cited by 835 radiologists (76%) as a means to decrease the likelihood of their recommending additional imaging. Conclusions: The 2010 JACR white paper on incidental abdominal CT findings has been read by a substantial number of radiologists, and among those who read it, the recommendations are being largely followed and are leading to a reduction in imaging recommendations. Future similar consensus-based white papers could lead to more consistent and effective management of incidental imaging findings and likely reduce the overall number of patients for whom additional imaging is recommended.