Discovery and disclosure of incidental findings in neuroimaging research.
OBJECTIVE
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.


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.


CONCLUSIONS
Guidelines for minimum and optimum standards for detecting and communicating incidental findings on brain MRI research are needed.
Illes
Judy
J
Stanford Center for Biomedical Ethics, Stanford University, Stanford, California 94304-5748, USA. iles@stanford.edu
Kirschen
Matthew P
MP
Karetsky
Kim
K
Kelly
Megan
M
Saha
Arnold
A
Desmond
John E
JE
Raffin
Thomas A
TA
Glover
Gary H
GH
Atlas
Scott W
SW
D035843:Biomedical Research / Q000941:ethics* / Q000706:statistics & numerical data; D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000175:diagnosis*; D030881:Disclosure / Q000941:ethics*; D019538:Health Care Surveys / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging / Q000941:ethics*