Observations Regarding the Detection of Abnormal Findings Following a Cancer Screening Whole-Body MRI in Asymptomatic Subjects: The Psychological Consequences and the Role of Personality Traits Over Time

Abstract

Background: The use of whole-body MRI (WB-MRI) in oncology has uncovered frequent unexpected abnormal findings (AFs). However, the impact of AFs on the patients' mental well-being is still poorly examined.

Purpose: To investigate the long-term psychological consequences of AF detection following WB-MRI for cancer screening in asymptomatic individuals.

Study type: Prospective, longitudinal.

Population: 121 consecutive subjects of the general population (mean age = 52.61 ± 11.39 years; 63% males) scheduled for cancer screening by WB-MRI.

Field strength/sequence: 1.5-T and 3-T; protocol complied with Oncologically Relevant Findings Reporting and Data System (ONCO-RADS) guidelines.

Assessment: Participants completed the first psychological investigation (T0) immediately after the WB-MRI. Subsequently, it was repeated after 1-year (T1), and 4-years (T2, subgroup of 61 participants) without an MRI exam, assessing personality traits, tumor risk perception, quality of life, depressive, and anxious symptoms. Radiologists directly reported WB-MRI findings to the participants, explaining the clinical implications and the location of the AFs. The number and severity of AFs were assessed.

Statistical tests: Pearson's correlations and analysis of variance with repeated measures assessed the psychological health variables' relationship and their changes over time. A P-value <0.05 was considered statistically significant.

Results: All participants presented AFs, with 101 individuals categorized as ONCO-RADS 2 and 19 as ONCO-RADS 3. The AFs were most prevalent in bones (31.5%). The overall participants showed only a slight increase in depressive symptoms at T1 [F(1,112) = 7.54]. The severity and the number of AFs were not significantly related to psychological changes [ranging from P = 0.503 to P = 0.997]. Depressive and anxious symptoms over time were significantly affected by the traits of conscientiousness [T1: F(1,112) = 7.87; T2: F(1.708,90.544) = 3.40] and openness [T1: F(1,112) = 4.41].

Data conclusion: Disclosing AFs by WB-MRI exams for cancer screening may not lead to long-term psychosocial consequences. Certain personality traits may, however, influence the psychological distress experienced by individuals with AFs after WB-MRI exams.

Technical efficacy: Stage 5.

Keywords: abnormal findings; cancer screening; psychological consequences; psychosocial health; whole‐body MRI.

FIGURE 1

Flow chart of the study population and data availability.