Incidental Finding on Brain MRI Seen in 5% of Older Patients

Incidental Finding on Brain MRI Seen in 5% of Older Patients

Pauline Anderson

May 11, 2020

New research shows that almost 5% of older British citizens have potentially serious brain abnormalities, including aneurysms, and about a third have blood test abnormalities.

Knowing the expected prevalence of such incidental findings in the older general population is “extremely useful” for both researchers and clinicians, study author Sarah Elisabeth Keuss, MBChB, Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK, told Medscape Medical News.

“In research, the knowledge helps to inform study protocols regarding how to manage incidental findings and enables study participants to be appropriately informed,” said Keuss.

Greater awareness also helps clinicians make decisions about whether or not to scan a patient, she said, adding that imaging is increasingly available to them.

It allows clinicians to counsel patients regarding the probability of an incidental finding and balance that risk against the potential benefits of having a test.

The research is being presented on as part of the American Academy of Neurology (AAN) 2020 Science Highlights. Due to the COVID-19 pandemic, the AAN had to cancel the 2020 annual meeting, April 25 to May 1, in Toronto, Canada.

The incidental findings were published last year in BMJ Open.

The new findings are from the first wave of data collection for the Insight 46 study, a neuroimaging substudy of the MRC National Survey of Health and Development (NSHD) 1946 British birth cohort, a broadly representative sample of the population born in mainland Britain during 1946.

The research uses detailed brain imaging, cognitive testing, and blood and other biomarkers to investigate genetic and life-course factors associated with Alzheimer’s disease and cerebrovascular disease.

The current study included 502 individuals, aged about 71 years at the time of the analysis, and 49% were women. Almost all (93.8%) participants underwent 1-day MRI scans.

Some 4.5% of these participants had an incidental finding of brain abnormality as per a prespecified standardized protocol.

Suspected vascular malformations were present in 1.9%, and suspected intracranial mass lesions were present in 1.5%. The single most common vascular abnormality was a suspected cerebral aneurysm, which affected 1.1% of participants.

Suspected meningiomas were the most common intracranial lesion, affecting 0.6% of study participants.

Action Plan

Participants and their primary care provider were informed of findings “that were deemed to be potentially serious, or life-threatening, or could have a major impact on quality of life,” said Keuss.