Imperial College London

Professor Paul M. Matthews

Faculty of MedicineDepartment of Brain Sciences

Edmond and Lily Safra Chair, Head of Department



+44 (0)20 7594 2855p.matthews




Ms Siobhan Dillon +44 (0)20 7594 2855




E502Burlington DanesHammersmith Campus






BibTex format

author = {Gibson, L and Littlejohns, T and Adamska, L and Garratt, S and Doherty, N and Wardlaw, J and Maskell, G and Parker, M and Brownsword, R and Matthews, P and Collins, R and Allen, N and Sellors, J and Sudlow, CLM and UK, Biobank Imaging Working Group},
doi = {10.12688/wellcomeopenres.13181.1},
journal = {Wellcome Open Research},
title = {Impact of detecting potentially serious incidental findings during multi-modal imaging},
url = {},
year = {2018}

RIS format (EndNote, RefMan)

AB - Background : There are limited data on the impact of feedback of incidental findings (IFs) from research imaging.  We evaluated the impact of UK Biobank’s protocol for handling potentially serious IFs in a multi-modal imaging study of 100,000 participants (radiographer ‘flagging’ with radiologist confirmation of potentially serious IFs) compared with systematic radiologist review of all images. Methods : Brain, cardiac and body magnetic resonance, and dual-energy x-ray absorptiometry scans from the first 1000 imaged UK Biobank participants were independently assessed for potentially serious IFs using both protocols. We surveyed participants with potentially serious IFs and their GPs up to six months after imaging to determine subsequent clinical assessments, final diagnoses, emotional, financial and work or activity impacts. Results : Compared to systematic radiologist review, radiographer flagging resulted in substantially fewer participants with potentially serious IFs (179/1000 [17.9%] versus 18/1000 [1.8%]) and a higher proportion with serious final diagnoses (21/179 [11.7%] versus 5/18 [27.8%]). Radiographer flagging missed 16/21 serious final diagnoses (i.e., false negatives), while systematic radiologist review generated large numbers of non-serious final diagnoses (158/179) (i.e., false positives). Almost all (90%) participants had further clinical assessment (including invasive procedures in similar numbers with serious and non-serious final diagnoses [11 and 12 respectively]), with additional impact on emotional wellbeing (16.9%), finances (8.9%), and work or activities (5.6%). Conclusions : Compared with systematic radiologist review, radiographer flagging missed some serious diagnoses, but avoided adverse impacts for many participants with non-serious diagnoses. While systematic radiologist review may benefit some participants, UK Biobank’s responsibility to avoid both unnecessary harm to larger numbers of
AU - Gibson,L
AU - Littlejohns,T
AU - Adamska,L
AU - Garratt,S
AU - Doherty,N
AU - Wardlaw,J
AU - Maskell,G
AU - Parker,M
AU - Brownsword,R
AU - Matthews,P
AU - Collins,R
AU - Allen,N
AU - Sellors,J
AU - Sudlow,CLM
AU - UK,Biobank Imaging Working Group
DO - 10.12688/wellcomeopenres.13181.1
PY - 2018///
TI - Impact of detecting potentially serious incidental findings during multi-modal imaging
T2 - Wellcome Open Research
UR -
ER -