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Incidental findings in brain MRI research: what do we owe our subjects?
Ronald J H Borra1, A Gregory Sorensen
1Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School Boston, Massachusetts 02129, USA. ronald.borra@tyks.fi
Abstract:
Concern regarding incidental findings on brain MRI studies has been increasing with the growing use of MRI as tool for scientific investigation. In this article, the authors provide an overview of possible approaches to address incidental findings. Incidental findings are surprisingly common (5%-20% of all examinations), although the percentage of clinically serious abnormalities is low (0.3%-3.4%). At present, there is no consensus concerning the optimal strategy on how to deal with incidental findings, in particular how to fulfill ethical responsibilities appropriately within the constraints of available resources. There are a variety of responses possible, and currently, reasonable guidelines exist for formulating a plan tailored to the needs of each institution that will meet the reasonable expectations of subjects participating in brain research studies.
Insights
Incidental findings on brain MRI scans are common, occurring in 5-20% of exams, but serious abnormalities are rare. Developing institutional guidelines is crucial for managing these findings ethically and effectively.
Area of Science:
- Neuroimaging
- Radiology
- Medical Ethics
Background:
- Increasing use of brain Magnetic Resonance Imaging (MRI) for research leads to more incidental findings.
- Incidental findings on brain MRI are common, ranging from 5% to 20% of examinations.
- Clinically significant abnormalities from incidental findings are infrequent, reported between 0.3% and 3.4%.
Purpose of the Study:
- To provide an overview of strategies for managing incidental findings in brain MRI studies.
- To address the lack of consensus on optimal approaches for handling incidental findings.
- To guide institutions in fulfilling ethical responsibilities towards research participants regarding incidental findings.
Main Methods:
- Review of current practices and literature regarding incidental findings on brain MRI.
- Analysis of ethical considerations and resource constraints in managing incidental findings.
- Development of a framework for institutional guideline creation.
Main Results:
- Incidental findings are a frequent occurrence in brain MRI research.
- The majority of incidental findings do not represent serious clinical abnormalities.
- No universal consensus exists on the best management strategy for incidental findings.
Conclusions:
- Institutions need tailored guidelines to manage incidental findings from brain MRI studies.
- Guidelines should balance ethical obligations to participants with available resources.
- A proactive approach to policy development is necessary for responsible research conduct.
