• J Illes, A C Rosen, L Huang, R A Goldstein, T A Raffin, G Swan, and S W Atlas.
• Stanford Center for Biomedical Ethics, Department of Medicine, Stanford University, Palo Alto, CA, USA. illes@stanford.edu
• Neurology. 2004 Mar 23; 62 (6): 888-90.

ObjectiveTo characterize the frequency and severity of incidental findings in brain MRIs of young and older adult research volunteers, and to provide an evaluation of the ethical challenges posed by the detection of such findings.MethodsThe authors reviewed 151 research MRI scans obtained retrospectively from subjects recruited to studies as healthy volunteers. Incidental findings were classified into four categories: no referral, routine, urgent, or immediate referral. p Values for significance were computed from chi(2) tests of contingency.ResultsOf 151 studies, the authors found an overall occurrence of incidental findings having required referral of 6.6%. By age, there were more findings in the older cohort (aged >60 years) than in the younger cohort (p < 0.05) and in more men than women in the older cohort (p < 0.001). Three of four (75%) findings in the younger cohort were classified in the urgent referral category; 100% of the findings in the older cohort were classified as routine (p < 0.05).ConclusionThe significant presence but different characteristics of incidental findings in young and older subjects presumed to be neurologically healthy suggest that standards of practice are needed to guide investigators in managing and communicating their discovery.

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