University of Washington Medicine radiologists are launching a new study to better understand incidental findings, including their associated costs, the Seattle-based university announced Monday.
With advances in medical imaging and an aging population, “incidentalomas” are increasingly common. Most of the time such findings are low-risk, but they can yield early cancers. It’s in the unknown middle grey area where follow-up scans, biopsies and costs begin to pile up.
“These apparent cancers have a wide spectrum of appearances. When we identify them, we usually don’t know whether they represent a cancer or whether there is short- or long-term risk,” Martin Gunn, MD, professor of radiology at UW Medicine, explained May 10. “We usually recommend follow-up with advanced imaging like ultrasound, CT, MRI, or nuclear medicine to find out and to ensure it does not grow.”
Gunn will co-lead a four-year study analyzing some 4 million radiology reports to assess how incidental findings impact morbidity, mortality and the cost-effectiveness of follow-up imaging and biopsies.
Backed by $2 million from the National Cancer Institutes, the group will focus on six common incidental lesions: lung, liver, kidney, pancreas, adrenal and thyroid gland.
Based off their findings and using software that automatically extracts information from radiology reports, the investigators will develop a database of records outlining follow-up costs, diagnoses and whether the finding led to a poor outcome. The tool will also list comorbidities and demographic info that may guide patients’ long-term health.
Take lung nodules for example, Gunn explained. Low-risk individuals with an incidentaloma of smaller than 6 millimeters face a cancer risk of less than 1%. That patient would only receive follow-up if they had a smoking history, he noted.
“At the other end of the spectrum, if the lung nodule is more than 1 centimeter, the cancer risk is substantially higher,” Gunn said. “So we’re hoping to better identify which cases are most appropriate to follow up, and what’s the best way to do that.”
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.