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

Published on May 1, 2021in JAMA Neurology13.608
· DOI :10.1001/JAMANEUROL.2021.0306
Yi Li94
Estimated H-index: 94
(UCSF: University of California, San Francisco),
Wesley K. Thompson71
Estimated H-index: 71
(UCSD: University of California, San Diego)
+ 106 AuthorsSandra A. Brown124
Estimated H-index: 124
(UCSD: University of California, San Diego)
Sources
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.
📖 Papers frequently viewed together
2 Citations
2 Citations
References29
Newest
#1Steven G. Heeringa (UM: University of Michigan)H-Index: 57
#2Patricia A. Berglund (UM: University of Michigan)H-Index: 46
Abstract: ABCD is a longitudinal, observational study of U.S. children, ages 9-10 at baseline, recruited at random from the household populations in defined catchment areas for each of 21 study sites. The 21 geographic locations that comprise the ABCD research sites are nationally distributed and generally represent the range of demographic and socio-economic diversity of the U.S. birth cohorts that comprise the ABCD study population. The clustering of participants and the potential for selectio...
16 CitationsSource
#1Donald J. Hagler (UCSD: University of California, San Diego)H-Index: 89
#2Sean N. Hatton (UCSD: University of California, San Diego)H-Index: 22
Last. Anders M. Dale (UCSD: University of California, San Diego)H-Index: 165
view all 143 authors...
Abstract The Adolescent Brain Cognitive Development (ABCD) Study is an ongoing, nationwide study of the effects of environmental influences on behavioral and brain development in adolescents. The main objective of the study is to recruit and assess over eleven thousand 9-10-year-olds and follow them over the course of 10 years to characterize normative brain and cognitive development, the many factors that influence brain development, and the effects of those factors on mental health and other o...
112 CitationsSource
#2Charles-Joris RouxH-Index: 3
Last. O. Naggara (Sorbonne)H-Index: 1
view all 10 authors...
BACKGROUND: The detection of incidental findings on children9s brain MR imaging poses various practical issues because the life-long implications of such findings may be profound. PURPOSE: Our aim was to assess the prevalence and characteristics of incidental brain MR imaging findings in children. DATA SOURCES: Electronic databases (PubMed, EMBASE, and Cochrane) were searched for articles published between 1985 to July 2018, with the following search terms: “incidental,” “findings,” “brain,” “MR...
8 CitationsSource
#1Giorgia Michelini (SBU: Stony Brook University)H-Index: 13
#2M Deanna (WashU: Washington University in St. Louis)H-Index: 106
Last. Roman Kotov (SBU: Stony Brook University)H-Index: 58
view all 6 authors...
Hierarchical dimensional systems of psychopathology promise more informative descriptions for understanding risk and predicting outcome than traditional diagnostic systems, but it is unclear how many major dimensions they should include. We delineated the hierarchy of childhood and adult psychopathology and validated it against clinically relevant measures. Participants were 9987 9- and 10-year-old children and their parents from the Adolescent Brain Cognitive Development (ABCD) study. Factor an...
32 CitationsSource
#1Wilson M. Compton (NIDA: National Institute on Drug Abuse)H-Index: 70
#2Gayathri J. Dowling (NIDA: National Institute on Drug Abuse)H-Index: 11
Last. Hugh Garavan (UVM: University of Vermont)H-Index: 90
view all 3 authors...
25 CitationsSource
#1Lorna Gibson (Edin.: University of Edinburgh)H-Index: 31
#2Laura Paul (Glasgow Royal Infirmary)H-Index: 1
Last. Cathie Sudlow (Edin.: University of Edinburgh)H-Index: 69
view all 8 authors...
Abstract Objectives To 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. Design Systematic review and meta-analyses. Data sources Citation searches of relevant articles and authors’ files in Medline and Embase (from inception to 25 April 2017). Review methods Eligible st...
24 CitationsSource
#1Hugh Garavan (UVM: University of Vermont)H-Index: 90
#2Hauke Bartsch (UCSD: University of California, San Diego)H-Index: 27
Last. D. Zahs (UM: University of Michigan)H-Index: 1
view all 10 authors...
Abstract The ABCD study is a new and ongoing project of very substantial size and scale involving 21 data acquisition sites. It aims to recruit 11,500 children and follow them for ten years with extensive assessments at multiple timepoints. To deliver on its potential to adequately describe adolescent development, it is essential that it adopt recruitment procedures that are efficient and effective and will yield a sample that reflects the nation’s diversity in an epidemiologically informed mann...
173 CitationsSource
#1B. J. Casey (Yale University)H-Index: 108
#2Tariq Cannonier (Yale University)H-Index: 1
Last. Anders M. Dale (UCSD: University of California, San Diego)H-Index: 165
view all 34 authors...
Abstract The ABCD study is recruiting and following the brain development and health of over 10,000 9–10 year olds through adolescence. The imaging component of the study was developed by the ABCD Data Analysis and Informatics Center (DAIC) and the ABCD Imaging Acquisition Workgroup. Imaging methods and assessments were selected, optimized and harmonized across all 21 sites to measure brain structure and function relevant to adolescent development and addiction. This article provides an overview...
374 CitationsSource
#1Philip R. JansenH-Index: 17
#2Marjolein H.G. Dremmen (EUR: Erasmus University Rotterdam)H-Index: 7
Last. Tonya White (Erasmus University Medical Center)H-Index: 65
view all 19 authors...
Brain MRI in 3966 children from the population-based Generation R Study (mean age, 10.1 years) revealed incidental findings in 25.6%. Most findings did not require neurosurgical intervention, but 7 children (0.18%) had suspected primary brain tumors.
37 CitationsSource
#1Nora D. Volkow (NIDA: National Institute on Drug Abuse)H-Index: 179
#2George F. Koob (NIH: National Institutes of Health)H-Index: 199
Last. Susan R. B. Weiss (NIDA: National Institute on Drug Abuse)H-Index: 14
view all 22 authors...
Abstract Adolescence is a time of dramatic changes in brain structure and function, and the adolescent brain is highly susceptible to being altered by experiences like substance use. However, there is much we have yet to learn about how these experiences influence brain development, how they promote or interfere with later health outcomes, or even what healthy brain development looks like. A large longitudinal study beginning in early adolescence could help us understand the normal variability i...
173 CitationsSource
Cited By0
Newest