incidental findings Archives - The Imaging Wire

Managing Incidental Findings Isn’t Impossible

Posted on September 14, 2025September 10, 2025 by Brian Casey

The number of incidental findings on medical imaging scans nearly quadrupled over nine years at a large academic medical center. That’s according to a new JACR analysis that fortunately offers strategies for following up on these unexpected imaging discoveries.

Incidental findings – defined as suspicious areas on medical images that aren’t related to a patient’s chief concern – comprise 15-30% of all medical imaging exams and are a growing challenge in radiology as imaging volume rises.

Radiologists have a responsibility to include incidental findings in their reports, but who’s responsible for making sure patients know about them?

Healthcare providers have adopted different methods for incidental follow-up, ranging from workflow changes to medical IT solutions.

In the current study, researchers from Northwestern University describe the incidental follow-up system they developed, which worked as follows…

An electronic button was embedded in the EMR for radiologists to click when an incidental finding was detected.
This relayed a note to the nursing team, which ensured that the patient’s care provider (or the patient themselves) knew about the finding.
The system required cases to be resolved when patients were notified of their findings and were told of the next steps to take.

In an analysis covering a total of 25.2k incidental findings from 2015 to 2023, researchers discovered…

The number of findings grew at a compound annual growth rate of 21% with an average of 233 per month.
Annual findings grew from 835 in 2015 to 4k in 2023 – a nearly 4X increase.
99% of findings were resolved.
Cases had to be resolved within seven months of the finding’s discovery.

One caveat is that Northwestern considered the loop closed once the patient was notified of the finding, rather than whether the patient complied with the recommendation.

A more robust protocol might involve additional longitudinal tracking to measure downstream effectiveness, which the authors note as a possibility for future research.

The Takeaway

The new study underscores the stunning growth of incidental findings in radiology. But it also offers hope to imaging facilities through implementation of a simple IT fix and workforce changes that go a long way toward keeping patients notified of their imaging results.

Integrated Solutions for Managing Incidental CAC Findings

Posted on May 7, 2025May 9, 2025 by Partner Content

The rising prominence of coronary artery calcium as a prognostic marker for heart disease has created an emerging challenge for radiologists: how should they manage incidental CAC findings discovered on routine CT exams? Fortunately, new industry collaborations are making it possible to deliver CAC reports to clinicians without disrupting workflow.

Routine CT scans are revealing data beyond their original diagnostic intent.

AI solutions – such as AVIEW CAC from Coreline Soft – play a pivotal role in identifying risks for cardiovascular disease, osteoporosis, and metabolic disorders – all from a single scan.

AI allows one CT scan to assess lung, cardiovascular, and skeletal health, improving diagnosis and treatment planning.

One imaging services provider that has put AVIEW CAC into use is 3DR Labs, which has been actively integrating the solution into its nationwide clinical network.

The partnership enables 3DR Labs radiologists to generate consistent, high-quality CAC reports directly within PACS, while significantly reducing turnaround times.

3DR Labs is finding that AVIEW CAC optimizes workflow efficiency and significantly reduces the time required for CAC assessment.

It also ensures that radiologic technologists can perform quick QA checks, enhancing consistency and reliability in the delivery of the report.

The latest generation of the FDA-cleared AVIEW CAC features an upgraded user interface and advanced batch-scoring functionality.

3DR Labs is now working to expand AI-driven insights into lung and neuroimaging through Coreline’s broader AVIEW platform (AVIEW ILA for interstitial lung abnormalities and AVIEW BAS for brain CT).

Beyond diagnostic imaging, this collaboration supports growing demands for cost-efficiency in healthcare.

As U.S. insurers and government agencies recognize the ROI potential of early AI detection, platforms like AVIEW CAC offer scalable, high-performance solutions that lower costs and streamline care delivery.

3DR Labs has also highlighted Coreline Soft’s role as a founding partner in AI Labs, the company’s vendor-neutral platform to deliver the latest AI innovations to radiology workflows.

The Takeaway

New partnerships like the collaboration between Coreline Soft and 3DR Labs are advancing the future of AI in radiology – focusing on automation, early detection, and better patient outcomes through powerful, clinically validated technologies. Such partnerships not only reflect increasing adoption of AI in U.S. healthcare but set the stage for global transformation in diagnostic imaging.

Incidental Findings and Low-Value Care

Posted on January 25, 2023January 25, 2023 by Jake Fishman

A whopping 15% to 30% of diagnostic imaging exams reveal at least one incidental finding. Each of those findings might seem like blessings to radiology outsiders, but a popular new AJR editorial argues that imaging incidentals are far more likely to drive low-value care.

Michigan Medicine’s Matthew Davenport, MD led-off his editorial by suggesting that early cancer detection “is not always an ideal outcome,” because most of those cancers won’t affect patient health, while incidental follow-ups always require resources and often negatively impact patients (physically, financially, and emotionally).

He identified numerous reasons for radiology’s incidental overdiagnosis challenges…

Screening low-risk patients inherently uncovers low-risk incidentals
There’s a lack of understanding of incidental risks (clinically and downstream)
Many early cancers don’t or shouldn’t require treatment
Radiologists face significant pressure to recommend follow-ups

Although many incidental findings significantly improve patient outcomes, and those positive examples have established incidentals as a “secondary benefit of imaging,” the editorial suggests that incidentals will have a negative overall impact on radiology’s value until current practices change.

So, what should we do? Dr. Davenport encourages radiologists to…

Become more aware of the harms of incidental management
Advocate for guidelines that emphasize high-value care
Support research on incidental management practices
“Avoid being alarmist” about incidentals in radiology reporting
Adopt solutions to help rads assess incidental patients’ risk factors
Balance diagnostic sensitivity with minimizing follow-up risks

The Takeaway

If you scroll through the Imaging Wire archives, you’ll find plenty of stories that depict incidentals as a net positive for patient care. In fact, most suggest that radiology’s research and business leaders are actively trying to find ways to detect more incidentals. However, efforts to better understand or to reduce incidentals’ negative impacts are far less common.

That divide is pretty notable given how many radiologists agree with Dr. Davenport, and it suggests that the barriers to solving incidental findings’ value problems are quite high.

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