Abstract
Objectives
The current study aims to investigate young adult research participants’ experiences with and preferences regarding the disclosure of MRI incidental findings (IFs) in brain imaging research, and to elucidate the impact and long-term effects of IF disclosure on these participants.
Methods
We conducted 11 semi-structured interviews with 10 research participants to whom an IF was disclosed after they participated in brain MRI research at the Donders Institute, Centre for Cognitive Neuroimaging (DCCN) in the Netherlands. Interview transcripts were analyzed using the constant comparative method.
Results
The analysis yielded five themes regarding the impact of IF disclosure: the initial shock of disclosure, a period of uncertainty, results of the follow-up examination, long-term impact, and participants’ biomedical background. Participants were primarily impacted by the uncertainty in the period immediately following IF disclosure. For our participants, disclosure has had no health benefits and some, albeit mostly temporary and limited, negative impact.
Conclusions
Our study suggests that it is important to carefully consider IF disclosure in a population of young healthy participants and emphasizes the relevance of systematic, large-scale follow-up studies to monitor risks and benefits of IF disclosure in this population. The insights from this study can be of added value to improve current research procedures or frameworks for the management and disclosure of IFs in imaging studies.
Key Points
• Participants were primarily impacted by the uncertainty in the period immediately following IF disclosure.
• Our study suggests that it is important to carefully consider IF disclosure in a population of healthy young adult participants.
• Our study emphasizes the relevance of systematic, large-scale follow-up studies to monitor the risks and benefits of IF disclosure in this population.
Similar content being viewed by others
Abbreviations
- AVM:
-
Arteriovenous malformation
- DCCN:
-
Donders Institute, Centre for Cognitive Neuroimaging
- GP:
-
General practitioner
- IF:
-
Incidental finding
References
Illes J (2003) Neuroethics in a new era of neuroimaging. AJNR Am J Neuroradiol 24:1739–1741
Bomhof CHC, van Bodegom L, Vernooij MW, Pinxten W, de Beaufort ID, Bunnik EM (2020) The impact of incidental findings detected during brain imaging on research participants of the Rotterdam Study: an interview study. Camb Q Healthc Ethics 29:542–556
Morris Z, Whiteley WN, Longstreth WT Jr et al (2009) Incidental findings on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ 339:b3016
Ikram MA, van der Lugt A, Niessen WJ et al (2015) The Rotterdam scan study: design update 2016 and main findings. Eur J Epidemiol 30:1299–1315
Poldrack RA, Farah MJ (2015) Progress and challenges in probing the human brain. Nature 526:371–379
Yousaf T, Dervenoulas G, Politis M (2018) Advances in MRI methodology. Int Rev Neurobiol 141:31–76
Poldrack RA (2008) The role of fMRI in cognitive neuroscience: where do we stand? Curr Opin Neurobiol 18:223–227
Wolf SM, Lawrenz FP, Nelson CA et al (2008) Managing incidental findings in human subjects research: analysis and recommendations. J Law Med Ethics 36(219–248):211
Gibson LM, Paul L, Chappell FM et al (2018) Potentially serious incidental findings on brain and body magnetic resonance imaging of apparently asymptomatic adults: systematic review and meta-analysis. BMJ 363:k4577
Borra RJ, Sorensen AG (2011) Incidental findings in brain MRI research: what do we owe our subjects? J Am Coll Radiol 8:848–852
Hoggard N, Darwent G, Capener D, Wilkinson ID, Griffiths PD (2009) The high incidence and bioethics of findings on magnetic resonance brain imaging of normal volunteers for neuroscience research. J Med Ethics 35:194–199
Takashima K, Takimoto Y, Nakazawa E et al (2017) Discovery and informing research participants of incidental findings detected in brain magnetic resonance imaging studies: Review and multi-institutional study. Brain Behav 7:e00676
Teuber A, Sundermann B, Kugel H et al (2017) MR imaging of the brain in large cohort studies: feasibility report of the population- and patient-based BiDirect study. Eur Radiol 27:231–238
Fullerton SM, Wolf WA, Brothers KB et al (2012) Return of individual research results from genome-wide association studies: experience of the Electronic Medical Records and Genomics (eMERGE) Network. Genet Med 14:424–431
Christenhusz GM, Devriendt K, Dierickx K (2013) To tell or not to tell? A systematic review of ethical reflections on incidental findings arising in genetics contexts. Eur J Hum Genet 21:248–255
Solomon BD (2014) Incidentalomas in genomics and radiology. N Engl J Med 370:988–990
Hallowell N, Hall A, Alberg C, Zimmern R (2015) Revealing the results of whole-genome sequencing and whole-exome sequencing in research and clinical investigations: some ethical issues. J Med Ethics 41:317–321
Wouters RHP, Cornelis C, Newson AJ, Bunnik EM, Bredenoord AL (2017) Scanning the body, sequencing the genome: dealing with unsolicited findings. Bioethics 31:648–656
Bredenoord AL, Kroes HY, Cuppen E, Parker M, van Delden JJ (2011) Disclosure of individual genetic data to research participants: the debate reconsidered. Trends Genet 27:41–47
Gibson LM, Littlejohns TJ, Adamska L et al (2017) Impact of detecting potentially serious incidental findings during multi-modal imaging. Wellcome Open Res 2:114
Schmidt CO, Hegenscheid K, Erdmann P et al (2013) Psychosocial consequences and severity of disclosed incidental findings from whole-body MRI in a general population study. Eur Radiol 23:1343–1351
Bunnik EM, van Bodegom L, Pinxten W, de Beaufort ID, Vernooij MW (2017) Ethical framework for the detection, management and communication of incidental findings in imaging studies, building on an interview study of researchers’ practices and perspectives. BMC Med Ethics 18:10
Weiner C (2013) Anticipate and communicate: Ethical management of incidental and secondary findings in the clinical, research, and direct-toconsumer contexts (December 2013 report of the Presidential Commission for the Study of Bioethical Issues). Am J Epidemiol 180(6):562–564
de Boer AW, Drewes YM, de Mutsert R et al (2018) Incidental findings in research: a focus group study about the perspective of the research participant. J Magn Reson Imaging 47:230–237
Reneman L, de Win MM, Booij J et al (2012) Incidental head and neck findings on MRI in young healthy volunteers: prevalence and clinical implications. AJNR Am J Neuroradiol 33:1971–1974
Acknowledgements
The authors wish to thank all interview participants for their generous participation.
Funding
The authors state that this work has not received any funding.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Guarantor
The scientific guarantor of this publication is Anke Oerlemans, Radboud University Medical Center, Nijmegen.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Informed consent
Written informed consent was obtained from all subjects (patients) in this study.
Ethical approval
Institutional Review Board approval was obtained.
Methodology
• retrospective
• qualitative study
• performed at one institution
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Oerlemans, A.J.M., Barendregt, D.M.H., Kooijman, S.C. et al. Impact of incidental findings on young adult participants in brain imaging research: an interview study. Eur Radiol 32, 3839–3845 (2022). https://doi.org/10.1007/s00330-021-08474-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00330-021-08474-9