[Management of incidental findings in neuroimaging in diagnosis and pathophysiological research]

Abstract

Structural, quantitative and functional neuroimaging has contributed greatly to the advancement in clinical diagnosis and research into pathophysiology of psychiatric disorders. In diagnostic investigations, the frequency of "incidental" findings, i. e. potentially pathological findings, which are unexpected with regards to the primary diagnostic question and which cannot be related to the presenting clinical symptomatology, amounts up to 30 %. Approximately 2 - 5 % of these unexpected findings have immediate clinical consequences. The analysis of incidental findings in the context of clinical diagnostic procedures allows to extrapolate on their prevalence in experimental studies, because here, such findings are not systematically documented. Several medical, ethical and legal problems arise related to the detection, evaluation and documentation of incidental findings in clinical experimental studies. These problems and resulting obligations will be discussed and solutions with respect to the management of incident findings will be proposed.