Follow-up care of incidental brain findings draws criticism

January 22, 2008 Diagnostic Imaging. Follow-up care of incidental brain findings draws criticism C. P. Kaiser -------------------------------------------------------------------------------- The number of brain MR scans obtained in the clinical and research setting increases each year, as scanner equipment and scanning protocols become ever more sensitive to subtle abnormalities. Many of these incidental findings are low risk and do not need rigorous imaging follow-up. Researchers therefore suggest revising management guidelines with an eye toward less radiological intervention. That conclusion was reached by investigators at Erasmus MC University Medical Center in Rotterdam, the Netherlands, after reviewing the brain scans of 2000 asymptomatic research subjects. They found that 1.6% of subjects had benign primary tumors, mainly meningiomas, classified by typical radiological characteristics such as location, shape, and signal intensity (NEJM 2007; 357[18]:1821-1828). Despite a documented slow growth rate for such asymptomatic tumors, current practice dictates close clinical and radiological follow-up.

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