This is a work in progress, but I humbly submit a draft proposal for a new multimodality standardized radiology grading schema: Sigh-RADS.
Sigh-RADS 1: Unwarranted & unremarkable
Sigh-RADS 2: Irrelevant incidental finding to be buried deep in the body of the report
Sigh-RADS 3: Incidental finding requiring nonemergent outpatient follow-up (e.g. pancreatic cystic lesion)
Sigh-RADS 4: Off-target clinically significant management-changing finding by sheer chance.
Sigh-RADS 5: Even broken clocks are correct twice a day (e.g. PE actually present on a CTA of the pulmonary arteries).
Sigh-RADS 6: Known malignancy staged/restaged STAT from the ED
Update (h/t @eliebalesh):
Sigh-RADS 0: Inappropriate and/or technically non-diagnostic exam for the stated clinical indication.