Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-23T10:18:42.381Z Has data issue: false hasContentIssue false
  • English
  • Français

The Risks and Benefits of Searching for Incidental Findings in MRI Research Scans

Published online by Cambridge University Press:  01 January 2021

Jason M. Royal  and
Bradley S. Peterson
Get access Rights & Permissions [Opens in a new window]

Extract

The question of how to handle incidental findings (IFs) has sparked a heated debate among neuroimaging researchers and medical ethicists, a debate whose urgency stems largely from the recent explosion in the number of imaging studies being conducted and in the sheer volume of scans being acquired. Perhaps the point of greatest controversy within this debate is whether the magnetic resonance imaging (MRI) scans of all research participants should be reviewed in an active search for pathology and, moreover, whether this search should be performed by a radiologist. Resistance to routine readings performed by radiologists, as opposed to selective review of those scans on which investigators have spotted a possible IF, has been fueled in part by the obvious and enormous cost — financial and logistical — of engaging radiologists to read massive numbers of scans. This cost would be especially burdensome, even prohibitive, to investigators who are not affiliated with a medical center, because of their limited access to radiologists and other medical expertise.

Type
Symposium
Information
Journal of Law, Medicine & Ethics , Volume 36 , Issue 2 , Summer 2008 , pp. 305 - 314
Copyright
Copyright © American Society of Law, Medicine and Ethics 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Davis, F. G. et al, “Prevalence Estimates for Primary Brain Tumors in the United States by Behavior and Major Histology Groups,” Neuro-Oncology 3, no. 3 (2001): 152–158.Google Scholar
Rinkel, G. J. et al, “Prevalence and Risk of Rupture of Intracranial Aneurysms: A Systematic Review,” Stroke 29, no. 1 (1998): 251–256; Wardlaw, J. M. and White, P. M., “The Detection and Management of Unruptured Intracranial Aneurysms,” Brain 123, Pt. 2 (2000): 205–221.Google Scholar
Lee, T. et al, “Aggregate Analysis of the Literature for Unruptured Intracranial Aneurysm Treatment,” American Journal of Neuroradiology, 26, no. 8 (2005): 1902–1908.Google Scholar
Meadows, J. et al, “Asymptomatic Chiari Type I Malformations Identified on Magnetic Resonance Imaging,” Journal of Neurosurgery 92, no. 6 (2000): 920–926.CrossRefGoogle Scholar
Illes, J. et al, “Ethical Consideration of Incidental Findings on Adult Brain MRI in Research,” Neurology 62, no. 6 (2004): 888–890; Katzman, G. L. et al, “Incidental Findings on Brain Magnetic Resonance Imaging from 1000 Asymptomatic Volunteers,” JAMA 282, no. 1 (1999): 36–39; Kim, B. S. et al, “Incidental Findings on Pediatric MR Images of the Brain,” American Journal of Neuroradiology 23, no. 10 (2002): 1674–1677; Kumra, S. et al, “Ethical and Practical Considerations in the Management of Incidental Findings in Pediatric MRI Studies,” Journal of the American Academy of Child and Adolescent Psychiatry 45, no. 8 (2006): 1000–1006; Weber, F. and Knopf, H., “Incidental Findings in Magnetic Resonance Imaging of the Brains of Healthy Young Men,” Journal of the Neurological Sciences 240, nos. 1–2 (2006): 81–84.CrossRefGoogle Scholar
Lubman, D. I. et al, “Incidental Radiological Findings on Brain Magnetic Resonance Imaging in First-Episode Psychosis and Chronic Schizophrenia,” Acta Psychiatrica Scandinavica 106, no. 5 (2002): 331–336.CrossRefGoogle Scholar
See Illes, et al, supra note 5.Google Scholar
de Leeuw, F. E. et al, “Prevalence of Cerebral White Matter Lesions in Elderly People: A Population Based Magnetic Resonance Imaging Study: The Rotterdam Scan Study,” Journal of Neurology, Neurosurgery & Psychiatry 70, no. 1 (2001): 9–14; Salonen, O. et al, “MRI of the Brain in Neurologically Healthy Middle-Aged and Elderly Individuals,” Neuroradiology 39, no. 8 (1997): 537–545.CrossRefGoogle Scholar
Illes, J. et al, “Discovery and Disclosure of Incidental Findings in Neuroimaging Research,” Journal of Magnetic Resonance Imaging 20, no. 5 (2004): 743–747.CrossRefGoogle Scholar
Illes, J. et al, “Incidental Findings in Brain Imaging Research,” Science 311, no. 5762 (2006): 783–784.CrossRefGoogle Scholar
See Kumra, et al, supra note 5.Google Scholar
See Weber, and Knopf, , supra note 5.Google Scholar