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Potentially relevant incidental findings on research whole-body MRI in the general adult population: frequencies and management

European Radiology volume 23, pages 816–826 (2013)Cite this article

Abstract

Objectives

To report the frequencies of potentially relevant incidental findings in the general adult population and to develop a protocol for their management in whole-body magnetic resonance imaging (wb-MRI).

Methods

A total of 2,500 adult subjects (1,271 women, 1,229 men; mean age 53 years) from the population-based Study of Health in Pomerania underwent standardised wb-MRI. Additionally, 1,129 participants received contrast-enhanced cardiac MRI, 619 men received MR angiography and 544 women received MR mammography. Two independent residents performed first-line reading. A third reader resolved disagreements. An interdisciplinary advisory board decided about disclosure.

Results

There were 1,330 incidental findings of potential clinical relevance in 904 subjects (36.2 %). Nine findings (0.4 %) required immediate referral. In total, 1,052 findings (79.1 %) were confirmed by the advisory board and disclosed to 787 participants (31.5 %). The abdominal organs (6.8 %), the urinary tract (6.8 %) and the skeletal system (6.0 %) were affected most often. While 383 findings (36.4 %) were indicated as benign and 62 (5.9 %) as malignant, most abnormalities, 607 (57.7 %), were of an unclear nature.

Conclusions

Potentially relevant incidental findings are very common in wb-MRI research but the nature of these findings remains unclear in most cases. This requires dedicated management to protect subjects’ welfare and research integrity.

Key Points

• Whole-body MRI (wb-MRI) research generates numerous incidental findings.

• Potentially relevant incidental findings are found in 32 % of participants.

• Some body regions generate many more incidental findings than others.

• The nature of incidental findings remains unclear in most cases.

• Managing incidental findings by an interdisciplinary voluntary advisory board is feasible.

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Abbreviations

BI-RADS:

Breast Imaging Reporting and Data System

SHIP:

Study of Health in Pomerania

wb-MRI:

whole-body MRI

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Acknowledgements

SHIP is part of the Community Medicine Research net of the University of Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (grant no. 03ZIK012), the Ministry of Cultural Affairs as well as the Social Ministry of the Federal State of Mecklenburg-West Pomerania. Whole-body MR imaging was supported by a joint grant from Siemens Healthcare, Erlangen, Germany and the Federal State of Mecklenburg-Vorpommern. The University of Greifswald is a member of the ‘Centre of Knowledge Interchange’ program of the Siemens AG. Dynamic contrast-enhanced MR mammography research is part of the entire whole-body MRI study and was supported by Bayer Healthcare. The work was further supported by the DFG (grant no. SCHM 2744/1-1).

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Affiliations

  1. Department of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Str. 1, 17475, Greifswald, Germany

    Katrin Hegenscheid, Rebecca Seipel, Jens-Peter Kühn, Norbert Hosten & Ralf Puls

  2. Department of Community Medicine, University Medicine Greifswald, Walter-Rathenau-Str. 48, 17475, Greifswald, Germany

    Carsten O. Schmidt & Henry Völzke

  3. Department of Prosthodontics, Gerostomatology and Biomaterials, Center of Oral Health, University Medicine Greifswald, Rotgeberstr. 8, 17487, Greifswald, Germany

    Reiner Biffar

  4. Department of Pharmacology, University Medicine Greifswald, Friedrich-Loeffler-Str. 23d, 17475, Greifswald, Germany

    Heyo K. Kroemer

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  1. Katrin Hegenscheid
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  2. Rebecca Seipel
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Correspondence to Katrin Hegenscheid.

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Hegenscheid, K., Seipel, R., Schmidt, C.O. et al. Potentially relevant incidental findings on research whole-body MRI in the general adult population: frequencies and management. Eur Radiol 23, 816–826 (2013). https://doi.org/10.1007/s00330-012-2636-6

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  • DOI: https://doi.org/10.1007/s00330-012-2636-6

Keywords

  • Magnetic resonance imaging
  • Whole body
  • Incidental findings
  • Prevalence
  • Management