Video: How To Handle Incidental Findings, Without Risk

December 6, 2011

CHICAGO - As the number of CT scans done in the US has climbed, so has the number of incidental findings - and the related malpractice risks for radiologists. Leonard Berlin, MD, in an interview on malpractice risk at RSNA 2011, says the right path isn't clear.

As the number of CT scans done in the US has climbed, so has the number of incidental findings - and the related malpractice risks for radiologists.

If, while reviewing an image of a lung, you happen to spy a possibly cancer on a kidney, do you ignore it and open yourself to a malpractice trial down the road if it turns out to be something? Do you obey the law of probability or look out for each individual patient?

Most incidentals, fully 99 percent, turn out to be meaningless. Drawing attention to them simply adds cost to the system and forces the patient to undergo possibly unnecessary tests and further radiation.

On the flip side, for any individual patient, ignoring the incidental could mean a disease goes un-diagnosed too long.

As Leonard Berlin, MD, put it in an interview on malpractice risk at RSNA 2011, patients don’t want to hear about statistics. They only care about their own bodies.

The appropriate choice for radiologists, he summarized, simply isn’t clear.