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Evaluation of Incidental Lesions Discovered at Imaging   Radiology   Associates   of   Indianapolis Richard L Scales MD
Indeterminate Lesions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Perspective on Incidentalomas ,[object Object],[object Object],[object Object],[object Object],[object Object]
Goals ,[object Object],[object Object],[object Object],[object Object]
Thyroid Incidentalomas   ,[object Object],[object Object],[object Object],[object Object],[object Object]
US Features of Benign Thyroid Nodules ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Copyright ©Radiological Society of North America, 2005 Frates, M. C. et al. Radiology 2005;237:794-800 Figure 1b. Punctate echogenicities in thyroid nodules
Malignant Thyroid Nodules ,[object Object],[object Object],[object Object],[object Object],[object Object]
Frequency of Occurrence of Thyroid Malignancies
US Features of Malignant Thyroid Nodules ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Malignant Thyroid Nodule
Nodule Selection for FNA ,[object Object],[object Object],[object Object],[object Object]
Consensus Statement Society of Radiologists in Ultrasound RSNA 2005
Thyroid Nodule Evaluation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nondiagnostic FNA ,[object Object],[object Object],[object Object],[object Object]
 
Summary ,[object Object],[object Object],[object Object]
Indeterminate Adrenal Nodules   “ Incidentalomas”
Incidentally Discovered Adrenal Lesions ,[object Object],[object Object],[object Object]
Adrenal Adenomas ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Imaging  Features of Adrenal Adenomas ,[object Object],[object Object],[object Object],[object Object],[object Object]
Copyright © 2007 by the American Roentgen Ray Society Dunnick, N. R. et al. Am. J. Roentgenol. 2002;179:559-568 --Lipid-rich adenoma in 74-year-old woman
Adrenal Lesion Size Asymptomatic Adult without History of Malignancy ,[object Object],[object Object],[object Object]
Diagnosis of Adrenal “Incidentaloma” ,[object Object],[object Object],[object Object]
Song, et al. AJR2007;189:1119-1123 ,[object Object],[object Object],[object Object],[object Object]
Song, et al ,[object Object],[object Object],[object Object],[object Object]
ACR Imaging Recommendations ,[object Object],[object Object],[object Object],[object Object]
 
 
Adrenal Imaging: Physicochemical Basis Fat ,[object Object],[object Object],[object Object]
Adrenal Imaging: Physicochemical Basis Washout ,[object Object],[object Object],[object Object]
Copyright ©Radiological Society of North America, 2001 Mayo-Smith, W. W. et al. Radiographics 2001;21:995-1012 Figure 15a. Indeterminate right adrenal mass found at CT in a 45-year-old woman with breast cancer
Copyright ©Radiological Society of North America, 2001 Mayo-Smith, W. W. et al. Radiographics 2001;21:995-1012 Figure 15b. Indeterminate right adrenal mass found at CT in a 45-year-old woman with breast cancer
Positive Diagnosis of Benign Adrenal Nodule (Adenoma) ,[object Object],[object Object],[object Object],[object Object]
Hyperfunctioning Adrenal Adenomas ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other Benign Adrenal Lesions ,[object Object],[object Object],[object Object],[object Object]
Adrenal Pseudocyst ,[object Object],[object Object],[object Object],[object Object]
Copyright © 2007 by the American Roentgen Ray Society Dunnick, N. R. et al. Am. J. Roentgenol. 2002;179:559-568 --Adrenal pseudocyst in 35-year-old woman
Myelolipoma ,[object Object],[object Object],[object Object],[object Object],[object Object]
Copyright ©Radiological Society of North America, 2001 Mayo-Smith, W. W. et al. Radiographics 2001;21:995-1012 Figure 26. Bilateral myelolipomas in a 79-year-old man
Chronic Inflammatory Disease ,[object Object],[object Object],[object Object],[object Object],[object Object]
Copyright © 2007 by the American Roentgen Ray Society Dunnick, N. R. et al. Am. J. Roentgenol. 2002;179:559-568 --Histoplasmosis in 68-year-old man
Adrenal Hemorrhage ,[object Object],[object Object],[object Object]
Copyright © 2007 by the American Roentgen Ray Society Dunnick, N. R. et al. Am. J. Roentgenol. 2002;179:559-568 --Adrenal hematoma in 75-year-old woman
“ Incidentaloma” Workup ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Benign Adrenal Lesions ,[object Object],[object Object],[object Object]
Indeterminate Adrenal Lesions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
“ Incidentaloma” Evaluation ,[object Object],[object Object],[object Object]
 
Advanced Adrenal Imaging ,[object Object],[object Object],[object Object]
Adrenal Metastases ,[object Object],[object Object],[object Object],[object Object]
Copyright © 2006 by the American Roentgen Ray Society Dunnick, N. R. et al. Am. J. Roentgenol. 2002;179:559-568 --Metastases from adenocarcinoma of lung in 34-year-old woman
Adrenal Carcinoma ,[object Object],[object Object],[object Object]
Imaging Features of Adrenal Carcinoma ,[object Object],[object Object],[object Object],[object Object]
Copyright ©Radiological Society of North America, 2001 Mayo-Smith, W. W. et al. Radiographics 2001;21:995-1012 Figure 25. Adrenal carcinoma in a patient who presented with left flank pain
Summary Adrenal Incidentaloma ,[object Object],[object Object],[object Object],[object Object],[object Object]
www.rai-imaging.com ,[object Object],[object Object]

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IncidentalomaTalk

  • 1. Evaluation of Incidental Lesions Discovered at Imaging Radiology Associates of Indianapolis Richard L Scales MD
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7. Copyright ©Radiological Society of North America, 2005 Frates, M. C. et al. Radiology 2005;237:794-800 Figure 1b. Punctate echogenicities in thyroid nodules
  • 8.
  • 9. Frequency of Occurrence of Thyroid Malignancies
  • 10.
  • 12.
  • 13. Consensus Statement Society of Radiologists in Ultrasound RSNA 2005
  • 14.
  • 15.
  • 16.  
  • 17.
  • 18. Indeterminate Adrenal Nodules “ Incidentalomas”
  • 19.
  • 20.
  • 21.
  • 22. Copyright © 2007 by the American Roentgen Ray Society Dunnick, N. R. et al. Am. J. Roentgenol. 2002;179:559-568 --Lipid-rich adenoma in 74-year-old woman
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.  
  • 29.  
  • 30.
  • 31.
  • 32. Copyright ©Radiological Society of North America, 2001 Mayo-Smith, W. W. et al. Radiographics 2001;21:995-1012 Figure 15a. Indeterminate right adrenal mass found at CT in a 45-year-old woman with breast cancer
  • 33. Copyright ©Radiological Society of North America, 2001 Mayo-Smith, W. W. et al. Radiographics 2001;21:995-1012 Figure 15b. Indeterminate right adrenal mass found at CT in a 45-year-old woman with breast cancer
  • 34.
  • 35.
  • 36.
  • 37.
  • 38. Copyright © 2007 by the American Roentgen Ray Society Dunnick, N. R. et al. Am. J. Roentgenol. 2002;179:559-568 --Adrenal pseudocyst in 35-year-old woman
  • 39.
  • 40. Copyright ©Radiological Society of North America, 2001 Mayo-Smith, W. W. et al. Radiographics 2001;21:995-1012 Figure 26. Bilateral myelolipomas in a 79-year-old man
  • 41.
  • 42. Copyright © 2007 by the American Roentgen Ray Society Dunnick, N. R. et al. Am. J. Roentgenol. 2002;179:559-568 --Histoplasmosis in 68-year-old man
  • 43.
  • 44. Copyright © 2007 by the American Roentgen Ray Society Dunnick, N. R. et al. Am. J. Roentgenol. 2002;179:559-568 --Adrenal hematoma in 75-year-old woman
  • 45.
  • 46.
  • 47.
  • 48.
  • 49.  
  • 50.
  • 51.
  • 52. Copyright © 2006 by the American Roentgen Ray Society Dunnick, N. R. et al. Am. J. Roentgenol. 2002;179:559-568 --Metastases from adenocarcinoma of lung in 34-year-old woman
  • 53.
  • 54.
  • 55. Copyright ©Radiological Society of North America, 2001 Mayo-Smith, W. W. et al. Radiographics 2001;21:995-1012 Figure 25. Adrenal carcinoma in a patient who presented with left flank pain
  • 56.
  • 57.