Hostname: page-component-745bb68f8f-b95js Total loading time: 0 Render date: 2025-01-11T02:07:42.895Z Has data issue: false hasContentIssue false
  • English
  • Français

The Prevalence of Incidental Findings in Multiple Sclerosis Patients

Published online by Cambridge University Press:  23 September 2014

J. Trufyn ,
M.D. Hill ,
J.N. Scott ,
J. Modi ,
V. Ciura ,
R. Frayne ,
M. Goyal ,
D. Lautner ,
D. Bhayana  and
W.J. Davenport
...Show all authors
J. Trufyn
Affiliation:
Departments of Clinical Neurosciences, University of Calgary, Boston, Massachusetts, USA Department of Neuroradiology (VC), Massachusetts General Hospital, Boston, Massachusetts, USA
M.D. Hill
Affiliation:
Departments of Clinical Neurosciences, University of Calgary, Boston, Massachusetts, USA Radiology, University of Calgary, Boston, Massachusetts, USA Community Health Services, University of Calgary, Boston, Massachusetts, USA
J.N. Scott
Affiliation:
Departments of Clinical Neurosciences, University of Calgary, Boston, Massachusetts, USA Radiology, University of Calgary, Boston, Massachusetts, USA
J. Modi
Affiliation:
Radiology, University of Calgary, Boston, Massachusetts, USA
V. Ciura
Affiliation:
Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada
R. Frayne
Affiliation:
Departments of Clinical Neurosciences, University of Calgary, Boston, Massachusetts, USA Radiology, University of Calgary, Boston, Massachusetts, USA Department of Diagnostic Imaging, Calgary, Alberta, Canada
M. Goyal
Affiliation:
Departments of Clinical Neurosciences, University of Calgary, Boston, Massachusetts, USA Radiology, University of Calgary, Boston, Massachusetts, USA
D. Lautner
Affiliation:
Department of Diagnostic Imaging, Calgary, Alberta, Canada
D. Bhayana
Affiliation:
Department of Diagnostic Imaging, Calgary, Alberta, Canada
W.J. Davenport
Affiliation:
Departments of Clinical Neurosciences, University of Calgary, Boston, Massachusetts, USA Medical Genetics, University of Calgary, Boston, Massachusetts, USA
J.K. Mah
Affiliation:
Seaman Family MR Research Centre, Foothills Medical Centre, Calgary, Alberta, Canada
J.M. Burton
Affiliation:
Departments of Clinical Neurosciences, University of Calgary, Boston, Massachusetts, USA
F. Costello*
Affiliation:
Departments of Clinical Neurosciences, University of Calgary, Boston, Massachusetts, USA Surgery (Ophthalmology), University of Calgary, Boston, Massachusetts, USA
*
Departments of Clinical Neurosciences and Surgery (Ophthalmology); University of Calgary, Foothills Medical Centre; Area 3, UCMC Health Sciences Centre 3350 Hospital Drive; Calgary, Alberta, T2N 4N1, Canada. Email: [email protected].
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

Incidental findings arising from imaging research have important implications for patient safety. Magnetic resonance imaging is widespread in multiple sclerosis (MS) studies and care, yet the prevalence rate of incidental findings in MS is poorly defined. The absence of such reports in the MS literature suggests that such findings may be deemed inappropriate for documentation in research publications, or possibly, not fully reported at all.

Objective:

We sought to document incidental findings from a study designed to detect features of chronic cerebrospinal venous insufficiency (CCSVI) in MS patients and control subjects.

Methods:

Magnetic resonance images were obtained as part of a prospective study conducted between October 2010 and September 2012. Patients with MS (relapsing-remitting, primary progressive, secondary progressive), clinically isolated syndromes, and neuromyelitis optica and age/sex-matched healthy controls were included. All images were reviewed by neuro-radiologists for quality-control purposes.

Results:

Magnetic resonance imaging was successfully obtained in 166 participants (110 patients, 56 controls). Incidental abnormalities (n = 33) were detected in 15% of patients (n = 17) and 27% of controls (n = 15), comprising 19% overall (n = 32).

Conclusions:

The prevalence of incidental findings from the MS population was not significantly different from the control population. However, the overall prevalence was high and warrants a careful management strategy for future imaging studies.

Résumé

RÉSUMÉ

Prévalence des découvertes fortuites chez les patients atteints de sclérose en plaques.

Contexte:

Les découvertes fortuites lors de l'imagerie faite dans un but de recherche ont des implications importantes pour la sécurité des patients. L'imagerie par résonance magnétique est courante dans les études et les soins dans la sclérose en plaques (SP), et pourtant le taux de prévalence des découvertes fortuites dans la SP est mal connu. L'absence de publications à ce sujet dans la littérature sur la SP suggère qu'on considère peut-être qu'il n'est pas approprié de les inclure lors de la publication des résultats de la recherche ou elles ne sont pas rapportées complètement.

Objectif:

Nous avons documenté les découvertes fortuites au cours d'une étude dont le but était de détecter des manifestations de l'insuffisance veineuse cérébrospinale chronique chez des patients atteints de SP et des sujets témoins.

Méthode:

L'imagerie par résonance magnétique a été obtenue au cours d'une étude prospective effectuée entre octobre 2010 et septembre 2012. Les patients atteints de SP (forme cyclique, progressive primaire, secondaire progressive), de syndromes isolés au point de vue clinique ainsi que de neuromyélite optique et des sujets témoins en bonne santé appariés pour l'âge et le sexe ont été inclus dans l'étude. Toutes les images ont été examinées par des neuroradiologistes à des fms de contrôle de la qualité.

Résultats:

l'IRM de 166 participants (110 patients et 56 témoins) a été étudiée. Des anomalies découvertes fortuitement (n = 33) ont été détectées chez 15% des patients (n = 17) et chez 27% des témoins (n = 15), soit au total chez 19% des participants (n = 32).

Conclusions:

La prévalence de découvertes fortuites dans le groupe de patients atteints de SP n'était pas significativement différente de celle du groupe témoin. Cependant, la prévalence globale était élevée et justifie une stratégie de gestion prudente lors d'études d'imagerie futures.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 41 , Issue 1 , January 2014 , pp. 49 - 52
Copyright
Copyright © The Canadian Journal of Neurological 2014

References

1. Palmour, N, Affleck, W, Bell, E, et al. Informed consent for MRI and fMRI research: analysis of a sample of Canadian consent documents. BMC Med Ethics. 2011;12:1.Google Scholar
2. Illes, J, Rosen, AC, Huang, L, et al. Ethical consideration of incidental findings on adult brain MRI in research. Neurology. 2004;62(6):888–90.Google Scholar
3. Katzman, GL, Dagher, AP, Patronas, NJ. Incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers. JAMA. 1999;282(1):36–9.Google Scholar
4. Shoemaker, JM, Holdworth, MT, Aine, C, et al. A practical approach to incidental findings in neuroimaging research. Neurology. 2011;77(24):2123–7.Google Scholar
5. Vernooij, MW, Ikram, MA, Tanghe, HL, et al. Incidental findings on brain MRI in the general population. N Engl J Med. 2007;357(18):1821–8.Google Scholar
6. Lublin, FD, Reingold, SC. Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Neurology. 1996;46(4): 907–11.Google Scholar
7. Compston, A, Coles, A. Multiple sclerosis. Lancet. 2008;372(9648): 1502–17.Google Scholar
8. Mancuso, AA Oh #*$%#! Another pesky incidental thyroid nodule! AJNR Am J Neuroradiol. 2005;26(10):2444–5.Google Scholar
9. Raymond, J, Long, H. Thyroid nodules and other incidentalomas: we must search for evidence and clarify our ethical priorities. AJNR Am J Neuroradiol. 2006;27(6):1163–4.Google Scholar
10. Illes, J, Kirschen, MP, Karetsky, K, et al. Discovery and disclosure of incidental findings in neuroimaging research. J Magn Reson Imaging. 2004;20(5):743–7.Google Scholar
11. Racine, E, Northoff, G, Menon, RS, Kimmelman, J, Illes, J. A Canadian perspective on ethics review and neuroimaging: tensions and solutions. Can J Neurol Sci. 2011;38(4):572–9.Google Scholar
12. Illes, J, Kirschen, MP, Edwards, E, et al. Ethics: incidental findings in brain imaging research. Science. 2006;311(5762):783–4.Google Scholar
13. Almond, B. Genetic profiling of newborns: ethical and social issues. Nat Rev Genet. 2006;7(1):67–71.Google Scholar
14. Shickle, D, Chadwick, R. The ethics of screening: is ‘screeningitis’ an incurable disease? J Med Ethics. 1994;20(1):12–8.Google Scholar
15. Rinkel, GJ Intracranial aneurysm screening: indications and advice for practice. Lancet Neurol. 2005;4(2):122–8.Google Scholar
16. Kalager, M, Zelen, M, Langmark, F, et al. Effect of screening mammography on breast-cancer mortality in Norway. N Engl J Med. 2010;363(13):1203–10.Google Scholar
17. Kirschen, MP, Jaworska, A, Illes, J. Subjects’ expectations in neuroimaging research. J Magn Reson Imaging. 2006;23(2):205–9.Google Scholar
18. Appelbaum, PS. Clarifying the ethics of clinical research: a path toward avoiding the therapeutic misconception. Am J Bioeth. 2002;2(2):22–3.Google Scholar