Management of Incidental Findings on Multimodal Imaging in UK Biobank

Abstract

UK Biobank is a major national health resource which aims to improve prevention, diagnosis and treatment of a wide range of serious and life-threatening illnesses. UK Biobank recruited 500,000 people aged between 40 and 69 years in 2006–2010, who underwent a range of measurements and provided detailed information about themselves, donated biological samples for future analyses and agreed to have their health followed long term. Among a range of ongoing enhancements, the UK Biobank Imaging Study aims to perform brain, cardiac and body magnetic resonance imaging, dual-energy X-ray absorptiometry and carotid Doppler ultrasound in 100,000 participants, generating the world’s largest multimodal imaging dataset.

As incidental findings (IF) are an expected consequence of its imaging study, UK Biobank developed a pragmatic, scalable protocol for handling IF, in which participants and their general practitioners receive feedback in limited circumstances: when, during image acquisition, a radiographer notices a potentially serious IF (‘indicating the possibility of a condition which, if confirmed, would carry a real prospect of seriously threatening life span or of having a substantial impact on major body functions or quality of life’) and a radiologist subsequently confirms a potentially serious IF.

UK Biobank has compared its IF protocol against a commonly used protocol (systematic review of all images by radiologists) and collected comprehensive data on the impact of feedback of potentially serious IF on participants and health services. The results will be published separately and will provide robust, empirical evidence to inform debates surrounding handling IF and designs of future studies’ IF policies.