Imaging-based screening: maximizing benefits and minimizing harms.

Area of Science:

• Medical Imaging
• Radiology
• Public Health

Background:

• Advanced imaging is crucial for screening asymptomatic individuals.
• The benefits versus risks of imaging screening are not always clear.
• Concerns include false positives, incidental findings, overdiagnosis, and radiation risks.

Purpose of the Study:

• To review controversies in imaging-based screening.
• To suggest areas for radiologists to improve screening benefits.
• To reduce harms associated with imaging screening.

Main Methods:

• Literature review of imaging screening controversies.
• Analysis of factors influencing screening outcomes.
• Discussion of strategies to optimize screening protocols.

Main Results:

• Imaging screening presents a complex benefit-risk balance.
• Key areas for improvement include interpretive variability and abnormal finding thresholds.
• Personalized, risk-based screening approaches are recommended.

Conclusions:

• Radiologists must address screening controversies to maximize patient benefit.
• Focusing on interpretive consistency and risk stratification can mitigate harms.
• Personalized screening strategies are essential for responsible use of advanced imaging.