Incidental findings

Information

Every now and then a researcher may notice an abnormality on an MRI scan of a healthy participant or patient. Rarely (in less than 5% of the cases) it concerns an abnormality that requires further action to be taken.

Action is only to be taken if the abnormality is treatable and if the abnormality has negative consequences for the health of the individual. The medical ethical committee of the AMC deems it inappropriate to inform a participant or patient of an untreatable abnormality, unless the individual presents with symptoms related to the abnormality.

If you notice an abnormality on an MRI scan, but you are unsure whether it is a relevant finding or not, it is possible to request a radiologist of the AMC to examine your scans. Before contacting the radiology department, please consult your colleagues to make sure that you are looking at something serious, which may affect the participant’s health, and not an artefact or a white matter abnormality.

Incidental Findings Form

Incidental findings need to be reported using incidental findings form. This form can be found in the 3T room on the red shelves or can be downloaded here (File:Request incidental findings.pdf).

Procedure

Reporting an incidental finding goes according to the following procedure:

• If you encounter an abnormality during scanning and if time allows, run an additional structural scan:
  • At the 3T, run a FLAIR.
  • At the 7T, run a T2-weighted scan.
    These protocols can be found in the exam card Other -> Incidental finding at both scanners.
• Fill in the incidental findings form (File:Request incidental findings.pdf). Note: you can omit the insurance number.
• Send your structural scans to “AMC-classic” (via 'send to network'). Specifically you should transfer:
  • a T1 scan.
  • If acquired, the FLAIR or T2. If it is not possible to provide a T2 scan, but you do have EPI images, provide a single dynamic together with the T1.
• Request Paul Groot (AMC Radiology, room Z0-182) to change the name to:

Name: 2000
Number: RESEARCH-2000
Acc#: Ayyyymmdd-hhmmss (so ‘year month day hour minute second’ of the moment of submission)

• Paul will forward the images and information, and will inform Tessa Oostendorp and the IT department about the incidental finding.
• Send an email to [email protected] and Trijntje Sjoerdsma to report your incidental finding.
• Bring the form to Tessa Oostendorp in C1-206, t. 63602.
• Tessa will create a patient ID, process the request and send it to the IT department of the radiology department.
• The IT department will link the research number to the patient ID and transfer the images to a radiologist.
• The radiologist writes a report and sends an email to the responsible researcher with the outcome of the examination.
• The researcher then notifies the general practitioner of the participant about the outcome in case of a positive finding.

Text for in the information leaflet

There is a (very small) chance that the MRI scan turns up an unusual finding in your brain. In the unlikely event that an unusual finding is substantial a radiologist will take a closer look and, if he feels it is warranted, will inform your GP. We need your consent prior to the scan and we will ask for the name and address of your GP. Should you decline, you will not be able to participate in the MRI research.

Text for informed consent

I hereby agree that in case of incidental finding my general practitioner may be notified.