Incidental findings and the need for a revised informed consent process

The current clinical practice with regard to incidental findings (IFs) is suboptimal in the domains of informed consent and patient education. We argue that a more robust informed consent process is needed to enable patients to anticipate incidentalomas and to correctly perceive the associated risks.

Given that IFs are very common in high-resolution imaging, patients should be provided information about the possibility of an IF as part of radiologic informed consent. The frequency of IFs, the very high rates of false-positives among incidentalomas, the very low rates of malignancies among incidentalomas, and the potential financial and emotional costs to both patients and the health care system of monitoring IFs necessitate a thorough informed consent process. Further, because radiologists are the most knowledgeable professionals regarding the nature of IFs, they should be the specialists who conduct the informed consent discussion with patients.