Imaging-based screening: maximizing benefits and minimizing harms

• Published in: Clinical imaging Vol. 40; no. 2; pp. 339 - 343
• Main Authors: Germino, Jessica C, Elmore, Joann G, Carlos, Ruth C, Lee, Christoph I
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2016; Elsevier Limited
• Subjects: Anatomy; Attention; Balancing; Benign; Breast cancer; Cardiovascular disease; Chest; Clinical trials; Colon; Colon cancer; Complications; Computed tomography; Coronary artery; Costs; Diagnostic Errors - statistics & numerical data; Diagnostic Imaging - methods; Disease prevention; Early Detection of Cancer - methods; Economic impact; False-positives; Heart diseases; Humans; Imaging; Imaging-based screening; Incidental Findings; Lung cancer; Magnetic resonance imaging; Mammography; Medical imaging; Medical screening; Neck; Neoplasms - diagnosis; Nodules; Organs; Overdiagnosis; Patients; Personalized; Quality of life; Radiation; Radiation effects; Radiology; Risk; Screening; Screening harms; Task forces; Thresholds; Thyroid; Thyroid gland; Tomography; Womens health; False-positives; Screening harms; Imaging-based screening; Overdiagnosis; Incidental findings
• ISSN: 0899-7071; 1873-4499
• DOI: 10.1016/j.clinimag.2015.06.003

Abstract Advanced imaging technologies play a central role in screening asymptomatic patients. However, the balance between imaging-based screening’s potential benefits versus risks is sometimes unclear. Radiologists will have to address ongoing concerns, including high false-positive rates, incidental findings outside the organ of interest, overdiagnosis, and potential risks from radiation exposure. In this article, we provide a brief overview of these recurring controversies and suggest the following as areas that radiologists should focus on in order to tip the balance toward more benefits and less harms for patients undergoing imaging-based screening: interpretive variability, abnormal finding thresholds, and personalized, risk-based screening.