Discovery and disclosure of incidental findings in neuroimaging research

Abstract

Purpose: To examine different protocols for handling incidental findings on brain research MRIs, and provide a platform for establishing formal discussions of related ethical and policy issues.

Materials and methods: Corresponding authors identified from a database of peer-reviewed publications in 1991-2002 involving functional MRI (fMRI), alone or in combination with other imaging modalities, were invited to participate in this web-based survey. The survey asked questions regarding knowledge and handling of incidental findings, as well as characteristics of the scanning environment, training required, IRB protocol requirements, and neuroradiologist involvement.

Results: Seventy-four investigators who conduct MRI studies in the United States and abroad responded. Eighty-two percent (54/66) reported discovering incidental findings in their studies, such as arteriovenous malformations, brain tumors, and developmental abnormalities. Substantial variability was found in the procedures for handling and communicating findings to subjects, neuroradiologist involvement, personnel permitted to operate equipment, and training.

Conclusion: Guidelines for minimum and optimum standards for detecting and communicating incidental findings on brain MRI research are needed.

Figure 1

Research personnel at different career levels who are permitted to conduct scans.

Figure 2

Neuroradiologist involvement. a: Frequency of neuroradiological review of research scans when neuroradiology involvement is not an IRB requirement. b: Lag time for neuroradiological readings of research scans. c: Frequency and type of neuroradiologist compensation.