Potentially relevant incidental findings on research whole-body MRI in the general adult population: frequencies and management

To report the frequencies of potentially relevant incidental findings in the general adult population and to develop a protocol for their management in whole-body magnetic resonance imaging (wb-MRI). A total of 2,500 adult subjects (1,271 women, 1,229 men; mean age 53 years) from the population-based Study of Health in Pomerania underwent standardised wb-MRI. Additionally, 1,129 participants received contrast-enhanced cardiac MRI, 619 men received MR angiography and 544 women received MR mammography. Two independent residents performed first-line reading. A third reader resolved disagreements. An interdisciplinary advisory board decided about disclosure. There were 1,330 incidental findings of potential clinical relevance in 904 subjects (36.2 %). Nine findings (0.4 %) required immediate referral. In total, 1,052 findings (79.1 %) were confirmed by the advisory board and disclosed to 787 participants (31.5 %). The abdominal organs (6.8 %), the urinary tract (6.8 %) and the skeletal system (6.0 %) were affected most often. While 383 findings (36.4 %) were indicated as benign and 62 (5.9 %) as malignant, most abnormalities, 607 (57.7 %), were of an unclear nature. Potentially relevant incidental findings are very common in wb-MRI research but the nature of these findings remains unclear in most cases. This requires dedicated management to protect subjects' welfare and research integrity. aEuro cent Whole-body MRI (wb-MRI) research generates numerous incidental findings. aEuro cent Potentially relevant incidental findings are found in 32 % of participants. aEuro cent Some body regions generate many more incidental findings than others. aEuro cent The nature of incidental findings remains unclear in most cases. aEuro cent Managing incidental findings by an interdisciplinary voluntary advisory board is feasible.