Exploring MRI incidental findings: incidence, ethical considerations, and clinical implications for TGen mobile lab MRI study
Incidental findings (IFs) occur in over 2% of MRI scans, presenting significant ethical and clinical challenges. Despite the widespread use of MRI, there has been limited guidance on managing IFs from portable MRIs, especially in diverse, rural populations with restricted healthcare access. This project investigates these challenges, focusing on the emerging use of portable MRIs within TGen’s Mobile Lab. Our analysis of existing policies and recommendations for traditional MRIs revealed substantial gaps when applied to portable MRI contexts. Traditional guidelines do not address issues such as AI usage in generating scans and the limited follow-up care available for participants in rural areas, complicating the ethical management of IFs in portable settings. To further understand participant expectations, we conducted an anonymous survey of TGen Mobile Lab participants. Results indicated that 94.8% of participants consented to receiving incidental findings, 92.7% desired results regardless of clinical significance, and 66.7% believed they benefited from participating in an MRI study. These findings underscore the value participants place on result transparency and ethical management that considers their expectations. Our study identified critical areas of concern and provided several recommendations to establish a consistent protocol for managing IFs in portable MRI settings. Key recommendations include establishing a clear threshold for clinical significance, ensuring explicit and comprehensible consent and protocol language, and specifying guidelines for returning results. Future studies should focus on implementing these recommendations, gathering more empirical evidence to refine our understanding, and exploring the role of government regulation in upholding participant protection and maintaining public confidence in research.
