A survey of primary investigators on a PET/CT imaging study showed agreement on returning clinically actionable findings to research participants but less consensus on managing unclear findings.
Disparate views on managing incidental imaging findings made during clinical research — particularly for unclear results — signal a need for standardized guidance, according to recent survey results.
The most common non-FDG–avid findings were pulmonary nodules, diverticulosis, cholelithiasis, sinus disease, and vascular calcifications. The most common FDG-avid findings were hypermetabolic lymphadenopathy, increased gastric/esophageal uptake, increased bowel uptake, and increased pharyngeal uptake.
“One of my subjects was found to have diverticulosis, which needed an invasive procedure to rule out malignancy,” one respondent wrote. “However, the subject had already had a colonoscopy months prior to the PET findings, which was still not deemed sufficient by the nuclear radiologist and GI consultant, so he had to have another colonoscopy, which was benign, but uncomfortable.
“Dealing in unknowns and uncertainties when you’re diagnosing doesn’t really do people very much good,” he toldWhile most survey respondents said they were at least moderately obligated to disclose incidental research findings if a patient requests them, Caplan noted that it was ultimately the researchers’ decision.
It’s possible that different sites responded to these ambiguous clinical findings in different ways, Kang noted.
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