Management of Incidental Pituitary Findings on CT, MRI, and 18 F-Fluorodeoxyglucose PET: A White Paper of the ACR Incidental Findings Committee

J Am Coll Radiol. 2018 Jul;15(7):966-972. doi: 10.1016/j.jacr.2018.03.037. Epub 2018 May 4.


The ACR Incidental Findings Committee presents recommendations for managing pituitary findings that are incidentally detected on CT, MRI and 18F-fluorodeoxyglucose PET. The Pituitary Subcommittee, which included radiologists practicing neuroradiology and an endocrinologist, developed this algorithm. The recommendations draw from published evidence and expert opinion and were finalized by informal iterative consensus. Algorithm branches successively categorize pituitary findings on the basis of imaging features. They terminate with an ascertainment of an indolent lesion (with sufficient confidence to discontinue follow-up) or a management recommendation. The algorithm addresses most, but not all, pathologies and clinical scenarios. The goal is to improve the quality of care by providing guidance on how to manage incidentally detected pituitary findings.

Keywords: Rathke’s cleft cyst; incidental; pituitary adenoma; pituitary lesion.

MeSH terms

  • Advisory Committees
  • Algorithms*
  • Fluorodeoxyglucose F18
  • Humans
  • Incidental Findings*
  • Magnetic Resonance Imaging
  • Pituitary Diseases / diagnostic imaging*
  • Positron-Emission Tomography
  • Radiopharmaceuticals
  • Societies, Medical
  • Tomography, X-Ray Computed


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18