[Management of incidental imaging findings – pancreas]
Parent M, Djossa Adoun S
Record ID 32018014978
French
Original Title:
Prise en charge des découvertes fortuites en imagerie médicale — pancréas
Authors' objectives:
Clinical management of incidentalomas poses several challenges that relate to the
management of uncertainty about the nature of an incidentally discovered lesion and its
level of risk. This uncertainty can lead to a significant number of follow-up tests with low
added value, which have consequences for the patient (risks associated with the
procedures, anxiety, absenteeism) and for the healthcare system (added workload and
extended wait times). To support clinical judgment and guide the practice of healthcare
professionals, INESSS has produced a clinical tool for the management of the most
frequent incidental findings in the pancreas. The pancreas is the first organ addressed in
the context of a broader project on incidental findings in medical imaging.
Authors' results and conclusions:
RESULTS (CLINICAL INDICATIONS): The full clinical indications are presented in the clinical tool accompanying this report. In
summary:
• No follow-up is generally indicated for a lesion with no risk of malignant
transformation, for a lesion measuring 5 mm or less, or for a patient unlikely to
benefit from this investigation (based on their preferences, age, or general
health). • Referral to a gastroenterologist to consider endoscopic ultrasound is indicated for
lesions that are 25 mm or larger, for significant lesion growth on follow-up
imaging, or in the presence of a worrisome feature on imaging (wall thickening,
mural nodules, dilation or abrupt change in the diameter of the main pancreatic
duct, lymphadenopathy).
Authors' recommendations:
In addition to clinical indications, the effective management of patients with pancreatic
incidentalomas could benefit from specific measures being taken at the level of
institutions and radiology departments:
• The use of standardized reports to describe incidental findings can contribute to
the effective communication of relevant characteristics for clinical management
decisions as well as the harmonization of practices.
Authors' methods:
A rapid literature review methodology was used to identify relevant recommendations
regarding management of incidental pancreatic findings in clinical practice guidelines and
systematic reviews. An advisory committee was formed to validate the interpretation of
the literature and adapt clinical indications to the Québec context.
Details
Project Status:
Completed
URL for project:
https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/prise-en-charge-des-decouvertes-fortuites-en-imagerie-medicale.html
Year Published:
2026
URL for published report:
https://www.inesss.qc.ca/fileadmin/doc/INESSS/Rapports/Usage_optimal/Fortuitomes_pancreas_GN_INESSS.pdf
English language abstract:
An English language summary is available
Publication Type:
Other
Country:
Canada
Province:
Quebec
MeSH Terms
- Pancreatic Diseases
- Incidental Findings
- Diagnostic Imaging
- Pancreatic Cyst
Contact
Organisation Name:
Institut national d'excellence en sante et en services sociaux
Contact Address:
L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369
Contact Name:
demande@inesss.qc.ca
Contact Email:
demande@inesss.qc.ca
Copyright:
L'Institut national d'excellence en sante et en services sociaux (INESSS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.