Incidental findings: Current ethical debates and future challenges in advanced neuroimaging

Abstract

The urgency to pragmatically address the challenges of managing incidental findings on neuroimaging is driven by the recent development of very large, population-based imaging studies, and ever-increasing use of imaging within research, clinical, and commercial sectors. Incidental findings are complex and variable. Their clinical significance ranges from benign to life-threatening; detection may be influenced by imaging, reader, and participant characteristics; and feedback may generate follow-up and anxiety. Appropriate management of incidental findings is therefore challenging, but essential in order to minimize negative impacts on participants, health services, individual research studies, and public trust in the wider community. This chapter summarizes current knowledge of the scale of the problem of incidental findings, factors influencing detection, potential impact, and public expectations. It highlights areas where robust, empirical data are needed to inform the design of feasible management policies and improve informed consent processes for the future.

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