Dataset Information

Rates of Incidental Findings in Brain Magnetic Resonance Imaging in Children.

ABSTRACT:

Importance

Incidental findings (IFs) are unexpected abnormalities discovered during imaging and can range from normal anatomic variants to findings requiring urgent medical intervention. In the case of brain magnetic resonance imaging (MRI), reliable data about the prevalence and significance of IFs in the general population are limited, making it difficult to anticipate, communicate, and manage these findings.

Objectives

To determine the overall prevalence of IFs in brain MRI in the nonclinical pediatric population as well as the rates of specific findings and findings for which clinical referral is recommended.

Design, setting, and participants

This cohort study was based on the April 2019 release of baseline data from 11 810 children aged 9 to 10 years who were enrolled and completed baseline neuroimaging in the Adolescent Brain Cognitive Development (ABCD) study, the largest US population-based longitudinal observational study of brain development and child health, between September 1, 2016, and November 15, 2018. Participants were enrolled at 21 sites across the US designed to mirror the demographic characteristics of the US population. Baseline structural MRIs were centrally reviewed for IFs by board-certified neuroradiologists and findings were described and categorized (category 1, no abnormal findings; 2, no referral recommended; 3; consider referral; and 4, consider immediate referral). Children were enrolled through a broad school-based recruitment process in which all children of eligible age at selected schools were invited to participate. Exclusion criteria were severe sensory, intellectual, medical, or neurologic disorders that would preclude or interfere with study participation. During the enrollment process, demographic data were monitored to ensure that the study met targets for sex, socioeconomic, ethnic, and racial diversity. Data were analyzed from March 15, 2018, to November 20, 2020.

Main outcomes and measures

Percentage of children with IFs in each category and prevalence of specific IFs.

Results

A total of 11 679 children (52.1% boys, mean [SD] age, 9.9 [0.62] years) had interpretable baseline structural MRI results. Of these, 2464 participants (21.1%) had IFs, including 2013 children (17.2%) assigned to category 2, 431 (3.7%) assigned to category 3, and 20 (0.2%) assigned to category 4. Overall rates of IFs did not differ significantly between singleton and twin gestations or between monozygotic and dizygotic twins, but heritability analysis showed heritability for the presence or absence of IFs (h2 = 0.260; 95% CI, 0.135-0.387).

Conclusions and relevance

Incidental findings in brain MRI and findings with potential clinical significance are both common in the general pediatric population. By assessing IFs and concurrent developmental and health measures and following these findings over the longitudinal study course, the ABCD study has the potential to determine the significance of many common IFs.

SUBMITTER: Li Y

PROVIDER: S-EPMC7985817 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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Publications

Rates of Incidental Findings in Brain Magnetic Resonance Imaging in Children.

Li Yi Y Thompson Wesley K WK Reuter Chase C Nillo Ryan R Jernigan Terry T Dale Anders A Sugrue Leo P LP Brown Julian J Dougherty Robert F RF Rauschecker Andreas A Rudie Jeffrey J Barch Deanna M DM Calhoun Vince V Hagler Donald D Hatton Sean S Tanabe Jody J Marshall Andrew A Sher Kenneth J KJ Heeringa Steven S Hermosillo Robert R Banich Marie T MT Squeglia Lindsay L Bjork James J Zucker Robert R Neale Michael M Herting Megan M Sheth Chandni C Huber Rebeka R Reeves Gloria G Hettema John M JM Howlett Katia Delrahim KD Cloak Christine C Baskin-Sommers Arielle A Rapuano Kristina K Gonzalez Raul R Karcher Nicole N Laird Angela A Baker Fiona F James Regina R Sowell Elizabeth E Dick Anthony A Hawes Samuel S Sutherland Matthew M Bagot Kara K Bodurka Jerzy J Breslin Florence F Morris Amanda A Paulus Martin M Gray Kevin K Hoffman Elizabeth E Weiss Susan S Rajapakse Nishadi N Glantz Meyer M Nagel Bonnie B Ewing Sarah Feldstein SF Goldstone Aimee A Pfefferbaum Adolf A Prouty Devin D Rosenberg Monica M Bookheimer Susan S Tapert Susan S Infante Maria M Jacobus Joanna J Giedd Jay J Shilling Paul P Wade Natasha N Uban Kristina K Haist Frank F Heyser Charles C Palmer Clare C Kuperman Joshua J Hewitt John J Cottler Linda L Isaiah Amal A Chang Linda L Edwards Sarah S Ernst Thomas T Heitzeg Mary M Puttler Leon L Sripada Chandra C Iacono William W Luciana Monica M Clark Duncan D Luna Beatriz B Schirda Claudiu C Foxe John J Freedman Edward E Mason Michael M McGlade Erin E Renshaw Perry P Yurgelun-Todd Deborah D Albaugh Matthew M Allgaier Nicholas N Chaarani Bader B Potter Alexandra A Ivanova Masha M Lisdahl Krista K Do Elizabeth E Maes Hermine H Bogdan Ryan R Anokhin Andrey A Dosenbach Nico N Glaser Paul P Heath Andrew A Casey Betty J BJ Gee Dylan D Garavan Hugh P HP Dowling Gaya G Brown Sandra S

JAMA neurology 20210501 5

<h4>Importance</h4>Incidental findings (IFs) are unexpected abnormalities discovered during imaging and can range from normal anatomic variants to findings requiring urgent medical intervention. In the case of brain magnetic resonance imaging (MRI), reliable data about the prevalence and significance of IFs in the general population are limited, making it difficult to anticipate, communicate, and manage these findings.<h4>Objectives</h4>To determine the overall prevalence of IFs in brain MRI in ...[more]

PMID: 33749724

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Project description:BACKGROUND:The neuroanatomic basis for cognitive impairment in chronic kidney disease (CKD) is incompletely characterized. We performed advanced quantitative structural magnetic resonance imaging (MRI) to determine whether CKD affects brain structure and whether poorer neurocognitive performance in CKD is associated with structural brain differences. STUDY DESIGN:Cross-sectional. SETTING & PARTICIPANTS:85 individuals with CKD stages 2 to 5 and 63 healthy controls, aged 8 to 25 years PREDICTORS: CKD versus control, estimated glomerular filtration rate (eGFR), and kidney transplant status were analyzed as predictors of MRI findings. MRI volumes in 19 prespecified regions of gray matter (GM), white matter (WM), and cerebrospinal fluid were analyzed as predictors of neurocognitive performance (median z scores) in 7 prespecified domains. OUTCOMES:19 prespecified brain regions of interest (ROIs) in 7 prespecified domains. Neurocognitive performance in 7 prespecified domains. MEASUREMENTS:ROI volumes were compared in CKD versus controls using unadjusted t tests and analysis of covariance (ANCOVA). Associations of ROI volumes with eGFR and kidney transplant status in participants with CKD were analyzed using ANCOVA and linear regression. Associations of neurocognitive performance and ROI volumes were analyzed by linear regression. RESULTS:Participants with CKD had lower whole-brain, cortical, and left parietal GM volumes than controls in unadjusted analyses, but no differences were found in adjusted analysis. In participants with CKD, lower eGFR was associated with higher WM volume in whole-brain (P=0.05) and frontal (P=0.04) ROIs, but differences were not significant after multiple comparisons correction. Kidney transplant recipients had lower GM volumes in whole-brain (P=0.01; Q=0.06), frontal (P=0.02; Q=0.08), and left and right parietal (P=0.01; Q=0.06; and P=0.03; Q=0.1) ROIs and higher whole-brain WM volume (P=0.04; Q=0.1). Neurocognitive performance in the CKD group was not associated with ROI volumes. LIMITATIONS:Unable to assess changes in brain structure and kidney function over time; analysis limited to prespecified ROIs and neurocognitive domains. CONCLUSIONS:CKD in children and young adults may be associated with lower GM and higher WM volumes in some ROIs. Differences were relatively subtle in the CKD group as a whole, but were more prominent in recipients of a kidney transplant. However, neurocognitive performance was not explained by differences in brain ROI volumes, suggesting a functional rather than structural basis for neurocognitive impairment in CKD.

Project description:ObjectivesTo determine prevalence and types of potentially serious incidental findings on magnetic resonance imaging (MRI) in apparently asymptomatic adults, describe factors associated with potentially serious incidental findings, and summarise information on follow-up and final diagnoses.DesignSystematic review and meta-analyses.Data sourcesCitation searches of relevant articles and authors' files in Medline and Embase (from inception to 25 April 2017).Review methodsEligible studies included prevalence and types of incidental findings detected among apparently asymptomatic adults undergoing MRI of the brain, thorax, abdomen, or brain and body. Data on study population and methods, prevalence and types of incidental findings, and final diagnoses were extracted. Pooled prevalence was estimated by random effects meta-analysis, and heterogeneity by τ2 statistics.Main outcome measuresPrevalence of potentially serious incidental findings on MRI of the brain, thorax, abdomen, and brain and body.ResultsOf 5905 retrieved studies, 32 (0.5%) met the inclusion criteria (n=27 643 participants). Pooled prevalence of potentially serious incidental findings was 3.9% (95% confidence interval 0.4% to 27.1%) on brain and body MRI, 1.4% (1.0% to 2.1%) on brain MRI, 1.3% (0.2% to 8.1%) on thoracic MRI, and 1.9% (0.3% to 12.0%) on abdominal MRI. Pooled prevalence rose after including incidental findings of uncertain potential seriousness (12.8% (3.9% to 34.3%), 1.7% (1.1% to 2.6%), 3.0% (0.8% to 11.3%), and 4.5% (1.5% to 12.9%), respectively). There was generally substantial heterogeneity among included studies. About half the potentially serious incidental findings were suspected malignancies (brain, 0.6% (95% confidence interval 0.4% to 0.9%); thorax, 0.6% (0.1% to 3.1%); abdomen, 1.3% (0.2% to 9.3%); brain and body, 2.3% (0.3% to 15.4%)). There were few informative data on potential sources of between-study variation or factors associated with potentially serious incidental findings. Limited data suggested that relatively few potentially serious incidental findings had serious final diagnoses (48/234, 20.5%).ConclusionsA substantial proportion of apparently asymptomatic adults will have potentially serious incidental findings on MRI, but little is known of their health consequences. Systematic, long term follow-up studies are needed to better inform on these consequences and the implications for policies on feedback of potentially serious incidental findings.Systematic review registrationProspero CRD42016029472.

Dataset Information

Rates of Incidental Findings in Brain Magnetic Resonance Imaging in Children.

Importance

Objectives

Design, setting, and participants

Main outcomes and measures

Results

Conclusions and relevance

Publications

Rates of Incidental Findings in Brain Magnetic Resonance Imaging in Children.

Similar Datasets

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