US is considered highly useful for real- time guidance for biopsy and establishing definitive diagnosis [11,12]. MRI Abdomen No comparative studies are available in the literature; however, there are several potential advantages to MRI that may advocate for its use in some instances. MRI possesses very high soft-tissue contrast, allowing depiction and differentiation of cystic structures, soft-tissue components, fat, and blood products [10]. This can be especially useful for defining benign from malignant lesions in organs such as the adrenal glands, kidneys, ovaries, and liver. Although MRI offers potential advantages, its exact performance in evaluating palpable masses relative to US and CT remains unclear given the absence of data; however, it is likely at least comparable. Although not always a first-line option, MRI can be very useful as a second-line imaging modality to further evaluate indeterminate masses detected on CT or US. Similar to CT, there is no evidence evaluating the utility and added benefit of IV contrast versus noncontrast MRI in the setting of a palpable intra-abdominal mass. Experience and evidence related to solid organ evaluation (liver, pancreas, and kidneys) suggests that IV contrast improves visualization of normal organs and pathology. However, there is some value in noncontrast MRI as it may still depict soft-tissue structures and delineate a mass. Radiography Abdomen Radiography is often not sufficient as a first step in evaluation of a palpable mass and hence the acquisition of cross-sectional imaging would likely be required for diagnosis regardless of the results of the radiograph [24,25]. Radiography may also be considered as a first step in rare situations. If the patient reports constipation, a radiograph could be used to confirm that diagnosis or to offer alternative diagnosis, such as bowel obstruction [26,27].
Palpable Abdominal Mass Suspected Neoplasm. US is considered highly useful for real- time guidance for biopsy and establishing definitive diagnosis [11,12]. MRI Abdomen No comparative studies are available in the literature; however, there are several potential advantages to MRI that may advocate for its use in some instances. MRI possesses very high soft-tissue contrast, allowing depiction and differentiation of cystic structures, soft-tissue components, fat, and blood products [10]. This can be especially useful for defining benign from malignant lesions in organs such as the adrenal glands, kidneys, ovaries, and liver. Although MRI offers potential advantages, its exact performance in evaluating palpable masses relative to US and CT remains unclear given the absence of data; however, it is likely at least comparable. Although not always a first-line option, MRI can be very useful as a second-line imaging modality to further evaluate indeterminate masses detected on CT or US. Similar to CT, there is no evidence evaluating the utility and added benefit of IV contrast versus noncontrast MRI in the setting of a palpable intra-abdominal mass. Experience and evidence related to solid organ evaluation (liver, pancreas, and kidneys) suggests that IV contrast improves visualization of normal organs and pathology. However, there is some value in noncontrast MRI as it may still depict soft-tissue structures and delineate a mass. Radiography Abdomen Radiography is often not sufficient as a first step in evaluation of a palpable mass and hence the acquisition of cross-sectional imaging would likely be required for diagnosis regardless of the results of the radiograph [24,25]. Radiography may also be considered as a first step in rare situations. If the patient reports constipation, a radiograph could be used to confirm that diagnosis or to offer alternative diagnosis, such as bowel obstruction [26,27].