Incidental findings on brain imaging and blood tests: results from the first phase of Insight 46, a prospective observational substudy of the 1946 British birth cohort
Jonathan M Schott,
Chandrashekar Hoskote,
David L Thomas,
Ashvini Keshavan,
Sarah-Naomi James,
Nick Fox,
Sachit Shah,
Sarah E Keuss,
Thomas D Parker,
Christopher A Lane,
David M Cash,
Sarah M Buchanan,
Heidi Murray-Smith,
Andrew Wong,
Kirsty Lu,
Jessica Collins,
Daniel G Beasley,
Ian B Malone,
Anna Barnes,
Marcus Richards
Affiliations
Jonathan M Schott
Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
Chandrashekar Hoskote
2 Lysholm Department of Neuroradiology, University College London Hospitals NHS Foundation Trust, London, UK
David L Thomas
5 Leonard Wolfson Experimental Neurology Centre, UCL Queen Square Institute of Neurology, London, UK
Ashvini Keshavan
1 Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
Sarah-Naomi James
MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
Nick Fox
1 Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
Sachit Shah
10 Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, UK
Sarah E Keuss
Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
Thomas D Parker
Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
Christopher A Lane
1 Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
David M Cash
Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
Sarah M Buchanan
Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
Heidi Murray-Smith
Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
Andrew Wong
7 MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
Kirsty Lu
Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
Jessica Collins
1University of Tasmania, Sandy Bay, TAS, Australia
Daniel G Beasley
4 School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
Ian B Malone
Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
Anna Barnes
7 Institute of Nuclear Medicine, University College London Hospitals, London, UK
Marcus Richards
MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
Objective To summarise the incidental findings detected on brain imaging and blood tests during the first wave of data collection for the Insight 46 study.Design Prospective observational sub-study of a birth cohort.Setting Single-day assessment at a research centre in London, UK.Participants 502 individuals were recruited from the MRC National Survey of Health and Development (NSHD), the 1946 British birth cohort, based on pre-specified eligibility criteria; mean age was 70.7 (SD: 0.7) and 49% were female.Outcome measures Data regarding the number and types of incidental findings were summarised as counts and percentages, and 95% confidence intervals were calculated.Results 93.8% of participants completed a brain scan (n=471); 4.5% of scanned participants had a pre-defined reportable abnormality on brain MRI (n=21); suspected vascular malformations and suspected intracranial mass lesions were present in 1.9% (n=9) and 1.5% (n=7) respectively; suspected cerebral aneurysms were the single most common vascular abnormality, affecting 1.1% of participants (n=5), and suspected meningiomas were the most common intracranial lesion, affecting 0.6% of participants (n=3); 34.6% of participants had at least one abnormality on clinical blood tests (n=169), but few reached the prespecified threshold for urgent action (n=11).Conclusions In older adults, aged 69-71 years, potentially serious brain MRI findings were detected in around 5% of participants, and clinical blood test abnormalities were present in around one third of participants. Knowledge of the expected prevalence of incidental findings in the general population at this age is useful in both research and clinical settings.
