Incidental liver lesion on CT
The guidance applies to incidental liver lesions in asymptomatic adult patients (>=18 years of age) for whom CT was requested for an unrelated reason.
The guidance was developed to distinguish benign from potentially malignant incidental findings, and not hepatic infections or abscesses, given that the latter are very likely to be associated with clinical signs or symptoms.
If a liver lesion presents with associated vascular invasion, biliary dilation, or adenopathy, the patient should be referred directly for oncologic evaluation.
Incidental liver lesions are very common, seen in up to 30% of individuals old than 40 years.
What is the size of the lesion?
Note:
For every incidental liver lesion, please evaluate the following elements: Lesion size. Lesion attenuation. Lesion homogeneity versus complexity. Lesion enhancement pattern. Lesion margin. Lesion multiplicity. Lesion growth pattern. Lesion location.
In general, absence of growth of a lesion over a 1-year time period strongly favors the presence of a benign lesion.