Important Recommendations for Pineal Cyst Management

Background: Since incidental pineal cysts are frequently detected, such as up to 20% on MRI examinations, it is important that the most appropriate patient management to address these findings be performed. A subcommittee of the American College of Radiology (ACR) Incidental Findings Committee was formed to formulate the most appropriate recommendations when a pineal cyst is detected. Objective: To make recommendations on the most appropriate management of incidental pineal cysts detected on imaging studies. Methods: The subcommittee consisted of experts in both neuroradiology and neurosurgery who used a formal consensus building process. MRI is considered the best modality for evaluating pineal cysts. MRI sequences should include a non-fat-saturated T1-weighted sequence without contrast, axial fluid-attenuated inversion recovery, axial diffusion-weighted imaging, and a postgadolinium volumetric T1-weighted image. If possible, other sequences such as a 3D, heavily T2-weighted image m more...