| Description | Recommendation | Notes |
| Gallstones, no mass | Evaluate with US if symptomatic | |
| Gallbladder wall calcification, no mass | No further evaluation | |
| Dense bile (20-100HU) | No further evaluation | |
| Diffuse gallbladder wall thickening >3mm, no mass | No further evaluation | |
| Focal gallbladder wall thickening or mass | Consider US for adenomyomatosis | Specific f/u depends on mass size, clinical factors |
| Gallbladder polyp ≤ 6 mm | No further evaluation | |
| Gallbladder polyp 7-9 mm | One year followup US | |
| Gallbladder polyp ≥ 10 mm, mass | Surgical consult | |
| Distended gallbladder | No further evaluation if asymptomatic | Further evaluation dependent on symptoms, labs |
| Common Bile Duct dilation | No further evaluation if labs normal | If labs abnormal: ERCP, EUS, MRCP or CT Cholangiography |
References:
Sebastian, S., et al. (2013). “Managing incidental findings on abdominal and pelvic CT and MRI, Part 4: white paper of the ACR Incidental Findings Committee II on gallbladder and biliary findings.” J Am Coll Radiol 10(12): 953-956.