Incidentaloma follow-up checker for kidney and adrenal lesions on CT
Paste a CT report. The app finds incidental kidney and adrenal lesions, applies Bosniak v2019, ACR 2018 and ESE/ENSAT 2023, and flags follow-up advice that is too weak or more than needed.
Results update as you type. Try editing a number: in the first sample, change 7 mm mural nodule to thin wall, or change a recommendation to Urology referral.
Every sample report run through the checker, sorted so the most serious gaps come first. Select a row to open that report.
| Report | Lesion | Guideline category | Guideline action | Report action | Flag |
|---|
| Feature | Category | Action |
|---|---|---|
| Macroscopic fat | Angiomyolipoma | None; urology if ≥4 cm |
| Cyst with enhancing nodule | Bosniak IV | Urology referral |
| Wall/septa ≥4 mm or irregular | Bosniak III | Urology referral |
| Wall/septa 3 mm, or ≥4 thin septa | Bosniak IIF | Imaging at 6 and 12 months, then yearly to 5 years |
| 1–3 thin septa; ≥70 HU unenhanced; 21–30 HU portal venous; too small to characterize | Bosniak II | None |
| Simple fluid (−9 to 20 HU), thin wall, no septa | Bosniak I | None |
| Solid, enhances ≥20 HU, no fat | Suspicious for RCC | Urology referral (<1 cm: imaging follow-up) |
| Anything else | Indeterminate | Renal mass protocol CT or MRI |
| Feature | Category | Action |
|---|---|---|
| <1 cm | Below threshold | None |
| Macroscopic fat | Myelolipoma | None |
| Homogeneous, ≤10 HU unenhanced | Lipid-rich adenoma | No imaging; 1 mg dexamethasone test |
| ≥4 cm or heterogeneous | Indeterminate, high risk | MDT review + hormonal work-up |
| >10 HU or no unenhanced phase | Indeterminate | More imaging + hormonal work-up |
Flags. Under-call: the guideline asks for something the report leaves out (high severity when a specialist referral is missing). Over-call: the report asks for follow-up the guideline does not. Any imaging meets an imaging requirement, and a referral covers one.
Simplified: CT only, no patient history, no adrenal washout.
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