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- Title
Research cardiac magnetic resonance imaging in end stage renal disease - incidence, significance and implications of unexpected incidental findings.
- Authors
Rutherford, Elaine; Weir-McCall, Jonathan; Patel, Rajan; Houston, J.; Roditi, Giles; Struthers, Allan; Jardine, Alan; Mark, Patrick; Weir-McCall, Jonathan R; Patel, Rajan K; Houston, J Graeme; Struthers, Allan D; Jardine, Alan G; Mark, Patrick B
- Abstract
<bold>Objectives: </bold>Left ventricular mass (LVM) at cardiac magnetic resonance imaging (CMR) is a frequent end point in clinical trials in nephrology. Trial participants with end stage renal disease (ESRD) may have a greater frequency of incidental findings (IF). We retrospectively investigated prevalence of IF in previous research CMR and reviewed their subsequent impact on participants.<bold>Methods: </bold>Between 2002 and 2006, 161 ESRD patients underwent CMR in a transplant assessment study. Images were used to assess LV mass and function. In the current study a radiologist reviewed the scans for IF. Review of patient records determined the subsequent clinical significance of IF.<bold>Results: </bold>There were 150 IF in 95 study participants. Eighty-four (56 %) were new diagnoses. One hundred and two were non-cardiac. Fifteen were suspicious of malignancy. There was a clinically significant IF for 14.9 % of the participants. In six cases earlier identification of an IF may have improved quality of life or survival.<bold>Conclusions: </bold>Without radiology support clinically important IF may be missed on CMR. Patients undergoing CMR in trials should be counselled about the frequency and implications of IF. Patients with ESRD have a higher prevalence of IF than reported in other populations. Nephrology studies require mechanisms for radiologist reporting and strategies for dealing with IF.<bold>Key Points: </bold>• Incidental findings on research cardiac magnetic resonance imaging can have significant consequences. • We considered incidental findings in historical renal cardiac resonance imaging clinical trials. • Incidental findings are common and important in the chronic kidney disease population. • Without radiology support, clinically significant incidental findings may be missed on imaging. • Study protocols, approvals and consent processes should take account of possible findings.
- Subjects
KIDNEY disease diagnosis; MAGNETIC resonance imaging; KIDNEY diseases; LEFT ventricular hypertrophy; CHRONIC kidney failure; PATIENTS; CHRONIC kidney failure complications; HEART disease complications; DIAGNOSIS; HEART; HEART diseases; MYOCARDIUM; DISEASE incidence; DISEASE prevalence; RETROSPECTIVE studies
- Publication
European Radiology, 2017, Vol 27, Issue 1, p315
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-016-4288-4