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Advanced Imaging Increases Incidentaloma Findings

By MedImaging International staff writers
Posted on 13 Aug 2018

Image: Cystic pancreatic incidentaloma in a 75-year-old woman with hematuria (Photo courtesy of NIH).

High-resolution magnetic resonance imaging (MRI) and positron emission technology (PET) scans increasingly distinguish incidental abnormalities that once went undetected, claims a new study.

Researchers at the University of Oxford (United Kingdom), Stanford University School of Medicine (CA, USA), and other institutions conducted an umbrella review of systematic reviews and meta-analyses of observational studies that reported prevalence of incidental abnormalities (incidentalomas) up to August 2017. An incidental imaging finding was defined as an imaging abnormality in a healthy, asymptomatic patient or an imaging abnormality in a symptomatic patient, where the abnormality was not apparently related to the patient’s symptoms.

The prevalence of incidentalomas varied substantially between imaging tests; it was less than 5% for chest computed tomography (CT) for incidental pulmonary embolism in patients with and without cancer and for whole body PET or PET/CT, also for patients with and without cancer; in these situations, incidentalomas were often found in blood vessels. Conversely, incidentalomas occurred in more than a third of images in cardiac MRI, chest CT, and CT colonoscopy. Intermediate rates occurred with MRI of the spine (22%) and brain (22%).

The rate of malignancy in incidentalomas varied substantially between organs; prevalence of malignancy was less than one hundredth of one percent in the brain, and less than 5% in incidentalomas of the parotid and adrenal gland. Extra-colonic, prostatic, and colonic incidentalomas were malignant 10-20% of the time, whereas renal, thyroid, and ovarian incidentalomas were malignant 25% of the time. Breast incidentalomas had the highest percentage of malignancy (42%), followed by 28% of incidentalomas in the ovaries and 11% in the prostate. The study was published on June 18, 2018, in The BMJ.

“Computed tomography of the chest, computed tomography colonoscopy, and cardiac MRI imaging scans have the highest frequencies of detecting incidentalomas,” concluded lead author Jack O’Sullivan, MSc, of Oxford University, and colleagues. “This umbrella review will help clinicians and patients weigh up the pros and cons of requesting imaging scans, and will assist with management decisions after an incidentaloma diagnosis. Our results can underpin the creation of guidelines to assist clinicians and patients through these decisions.”

Related Links:
University of Oxford
Stanford University School of Medicine

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70 (420.09353637695): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294774464 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 4769.0868377686): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294774464 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (74.863433837891): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (136.13700866699): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (61.03515625): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (40.769577026367): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (50.067901611328): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294774464 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (30.040740966797): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294774464 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (33.855438232422): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (!!!!! 1517.7726745605): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (78.916549682617): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (58.889389038086): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (49.829483032227): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 2072.0958709717): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

105 (101.08947753906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

106 (94.175338745117): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294774464 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (62.942504882812): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294774464 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (416.99409484863): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

109 (122.0703125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

110 (168.80035400391): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294774464 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (614.16625976562): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294774464 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (859.97581481934): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (574.82719421387): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (116.82510375977): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

115 (122.0703125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

116 (85.115432739258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

117 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

118 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

119 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

120 (339.98489379883): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 96238.851547241): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (128.03077697754): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

123 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

124 (518.0835723877): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294774464 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294774464 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 960486.8888855): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (106.0962677002): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (59.127807617188): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (35.04753112793): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (61.03515625): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (35.04753112793): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (33.140182495117): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (30.994415283203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (664.94941711426): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (593.90068054199): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (51.021575927734): SELECT name FROM jos_deeppockets WHERE id=215

136 (43.869018554688): SELECT name FROM jos_deeppockets WHERE id=215

137 (698.08959960938): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (469.92301940918): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (150.91896057129): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

140 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

141 (!!!!! 41880.130767822): TRUNCATE TABLE jos_trademed_module

142 (!!!!! 1837.9688262939): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294774464 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (107.0499420166): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294774464 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (!!!!! 7840.8718109131): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (155.21049499512): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (111.81831359863): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

147 (64.13459777832): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

148 (!!!!! 1709.9380493164): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (144.95849609375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

150 (74.863433837891): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

151 (57.220458984375): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294774464 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294774464 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (51.021575927734): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

153 (46.968460083008): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

154 (889.06288146973): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (91.075897216797): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

156 (49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294774464 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294774464 AND published='1' LIMIT 1

157 (486.13548278809): select jos_twitters.link from jos_twitters where cat=10

158 (!!!!! 5310.05859375): select jos_facebook.link from jos_facebook where cat=10

159 (!!!!! 4771.9478607178): select jos_google_plus.link from jos_google_plus where cat=10

160 (483.03604125977): select jos_linkedin.link from jos_linkedin where cat=10

161 (574.11193847656): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 5412.1017456055): insert into jos_banners_delta values (14615,'2025-06-20 04:00:08','216.73.216.120','view'),(14202,'2025-06-20 04:00:08','216.73.216.120','view'),(14203,'2025-06-20 04:00:08','216.73.216.120','view')

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