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

Table 3 Key distinctions between the American College of Radiology incidental findings guidelines and the proposed Incidental-Reporting and Data System

Feature	ACR incidental findings guidelines	I-RADS proposal
Scope	Organ- and condition-specific	Universal, modality-agnostic, and pan-anatomical
Format	White papers and detailed flowcharts, often requiring consultation of multiple documents	Single classification system with 6 categories applicable to any incidental finding
Goal	Provide evidence-based management recommendations for specific incidental findings	Provide standardized language and structured framework to classify all incidental findings
Strengths	Evidence-based, specialty consensus; addresses details of particular lesions	Simple, unified terminology, allowing easier communication, reporting consistency, and research data harmonization
Limitations	Spread across multiple documents, not integrated into a universal framework	Broad by design, requires integration with organ-specific guidelines for detailed management
Complementarity	Offers depth for specific lesions	Provides an all-embracing framework into which ACR guidelines can be fused

The American College of Radiology guidelines offer detailed recommendations for specific organs and clinical scenarios, while Incidental-Reporting and Data System introduces a simple unifying classification system appropriate across modalities and anatomical regions. Together, they provide depth and consistency, supporting more standardized communication and incidental finding management. ACR: American College of Radiology; I-RADS: Incidental-Reporting and Data System.