Management of Incidental Inspissated Secretions on CT

Initial Assessment and Management

The American College of Radiology guidance does not apply to symptomatic or high-risk patients with incidental findings, and these patients require further evaluation 1, 2
In asymptomatic patients with isolated inspissated secretions and no concerning features, no routine follow-up imaging is required 1, 2
For patients with known malignancy, smoking history, or immunosuppression, a lower threshold for additional imaging or bronchoscopy is recommended, and consideration of 3-month follow-up CT if bronchoscopy is deferred 1
When documenting inspissated secretions as an incidental finding, precise location and extent of secretions should be included, as well as associated findings and specific recommendations for follow-up 1

The American College of Radiology recommends using definitive language to avoid unnecessary downstream testing, such as stating clearly whether follow-up is needed or if the finding is likely benign 1, 2
Effective communication of findings is crucial, and use of closed-loop communication systems is recommended when recommendations are made 1