CAR Recommendations for the Management of Incidental Findings of the Spleen and Nodes in Adults

Jeffery R Bird, Gary L Brahm, Christopher I Fung, Wendy Tu, Isabelle-Jiamin Zheng, Iain D C Kirkpatrick
Can Assoc Radiol J. 2025 Jun 25:8465371251346732. doi: 10.1177/08465371251346732. Online ahead of print.
Abstract
The Canadian Association of Radiologists Incidental Findings Working Group (CAR IFWG) has developed new recommendations for the management of incidental findings of the spleen, lymph nodes, peritoneum, and mesentery, tailored to the Canadian healthcare context. This guidance addresses splenomegaly, focal splenic lesions, splenic artery aneurysms, lymphadenopathy, mesenteric panniculitis, and peritoneal nodules. Building on prior American College of Radiology (ACR) guidance and integrating recent evidence, the CAR IFWG offers a pragmatic approach emphasizing radiologic features, clinical context, and patient risk factors to minimize unnecessary follow-up. The recommendations aim to streamline care, reduce patient anxiety, and support radiologists in distinguishing benign from potentially malignant findings in asymptomatic individuals.