Practical approaches to incidental findings in brain imaging research

Neurology. 2008 Jan 29;70(5):384-90. doi: 10.1212/01.wnl.0000280469.17461.94.


A decade of empirical work in brain imaging, genomics, and other areas of research has yielded new knowledge about the frequency of incidental findings, investigator responsibility, and risks and benefits of disclosure. Straightforward guidance for handling such findings of possible clinical significance, however, has been elusive. In early work focusing on imaging studies of the brain, we suggested that investigators and institutional review boards must anticipate and articulate plans for handling incidental findings. Here we provide a detailed analysis of different approaches to the problem and evaluate their merits in the context of the goals and setting of the research and the involvement of neurologists, radiologists, and other physicians. Protecting subject welfare and privacy, as well as ensuring scientific integrity, are the highest priorities in making choices about how to handle incidental findings. Forethought and clarity will enable these goals without overburdening research conducted within or outside the medical setting.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Brain / pathology
  • Brain / physiopathology
  • Brain Diseases / diagnosis*
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / therapy
  • Clinical Protocols / standards
  • Clinical Trials as Topic / ethics
  • Clinical Trials as Topic / standards
  • Confidentiality / standards
  • Consent Forms / standards
  • Diagnostic Imaging / ethics
  • Diagnostic Imaging / standards*
  • Disclosure / standards
  • Hemangioma, Cavernous, Central Nervous System / diagnosis
  • Hemangioma, Cavernous, Central Nervous System / therapy
  • Humans
  • Incidental Findings*
  • Intracranial Arteriovenous Malformations / diagnosis
  • Intracranial Arteriovenous Malformations / therapy
  • Patient Care Team / ethics
  • Patient Care Team / standards
  • Physician-Patient Relations / ethics*
  • Referral and Consultation / ethics
  • Referral and Consultation / standards