Proposing Incidental-Reporting and Data System: A classification system for incidental findings in radiology

Table 1 Proposed Incidental-Reporting and Data System scoring and recommendations

I-RADS category	Description	Recommended action
I-RADS 0	Incomplete/insufficient information	Retrieve prior imaging (if not feasible, consider escalation to targeted imaging or reassignment to a higher category)
I-RADS 1	Incidental benign finding - no clinical significance	No follow-up or further work-up required
I-RADS 2	Probably benign - minimal concern	Optional follow-up (i.e., 6-12 months)
I-RADS 3	Indeterminate - moderate concern	Recommend follow-up (i.e., 3-6 months) and/or targeted imaging
I-RADS 4	Suspicious - likely pathology	Further imaging or work-up warranted
I-RADS 5	Highly suspicious - urgent concern	Immediate work-up, appropriate referral, possible biopsy
I-RADS 6	Known/confirmed pathology	No additional work-up required - continue routine or disease-specific management as applicable

I-RADS: Incidental-Reporting and Data System.