Incidental findings in whole-body MR imaging of a population-based cohort study: Frequency, management and psychosocial consequences

• Published in: European journal of radiology 2021-01, Vol.134, p.109451, Article 109451
• Main Authors: Schlett, Christopher L., Rospleszcz, Susanne, Korbmacher, Dorina, Lorbeer, Roberto, Auweter, Sigrid, Hetterich, Holger, Selder, Sonja, Heier, Margit, Linkohr, Birgit, Weckbach, Sabine, Ertl-Wagner, Birgit, Peters, Annette, Bamberg, Fabian
• Format: Article
• Language: English
• Subjects: Cohort Studies; Epidemiologic study; Female; Germany - epidemiology; Humans; Incidental finding; Incidental Findings; Magnetic Resonance Imaging; Male; Patient care management; Prospective Studies; Psychosocial aspects; Whole body imaging
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2020.109451

•Whole-Body, contrast-enhanced MR imaging in a population-based cohort yielded high prevalence of IF, mainly in the abdomen.•In population research, participants considered reporting of IF highly important, which further increased after undergoing whole-body MR imaging.•Reporting of clinically relevant IF added only minor psychological burden. Management of incidental findings (IF) remains controversial but highly relevant. Our aim was to assess the frequency, management and psychosocial consequences of IF reporting in a population-based cohort study undergoing whole-body MR imaging. The study was nested in a prospective cohort from a longitudinal, population-based cohort (KORA-FF4) in southern Germany. All MR obtained on 3 T MR scanner were reviewed by board-certified radiologists regarding clinically relevant IF. A baseline and follow-up questionnaires including PHQ-9 were completed prior to and 6-month after to the scan. Of 400 participants (56.3 ± 9.2years, 58 % male) undergoing whole-body MR, IF were found in 22 % of participants (n = 89); most frequently located in the abdominal sequences. In the pre-scan survey, most participants stated as the motivation that they wanted to “contribute to a scientific purpose” (91 %), while “knowing whether I’m healthy” was the most frequent motivation reported 6 months post-scan (88 %). The desire for IF reporting increased over time (pre- vs. 6-months-post-scan), also for clinically less important IF (72 % vs. 84 %, p = 0.001). Regarding psychosocial impact, a small portion (3.4 %) reported that awaiting the IF report added “definitely” or “very probably” additional stress burden. Of participants with reported IF, 56.8 % classified the results as “very helpful”. In the post-scan survey moderate depression was observed in 3.3 % and severe depression in 1.2 %. This did not differ between participants with and without reported IF. In a cohort with whole-body MR imaging, the prevalence of IF was high. Participants considered reporting of IF highly important and added only minor psychological burden.