| Description | Recommendation | Notes |
| Prior imaging: Stable x 1 yr | No further evaluation | |
| Prior imaging: Not stable | Evaluate with PET, MR, biopsy | |
| Cancer history, < 1cm | MRI in 6-12 months | |
| Cancer history, ≥ 1cm | Evaluate with PET, MR, biopsy | |
| No cancer history, suspicious features | Evaluate with PET, MR, biopsy | Heterogeneous enhancement irregular margins, necrosis |
| No cancer history,
indeterminate features |
MRI in 6-12 months | Heterogeneous, >20 HU, enhancement, smooth margins |
| Diagnostic benign findings | No further evaluation | Homogenous, <20 HU, non-enhancing, smooth margins |
References:
Heller, M. T., et al. (2013). “Managing Incidental Findings on Abdominal and Pelvic CT and MRI, Part 3: White Paper of the ACR Incidental Findings Committee II on Splenic and Nodal Findings.” J Am Coll Radiol 10(11): 833-839.