The Incidentaloma: A Medicolegal Dilemma

Radiologic Clinics of North America

Volumn 49, Issue 2, 2011, Pages 245-255

  Berlin, Leonard ^a,b  

^a RUSH MEDICAL COLLEGE   (United States)

^b NORTHSHORE UNIVERSITY HEALTHSYSTEM   (United States)

Author keywords

Incidentalomas; Malpractice; Medicolegal

Indexed keywords

ANTIBIOTIC AGENT; ANTINEOPLASTIC AGENT; DECONGESTIVE AGENT;

ABDOMINAL ABSCESS; CHRONIC OBSTRUCTIVE LUNG DISEASE; CHRONIC SINUSITIS; COMPUTER ASSISTED TOMOGRAPHY; DELAYED DIAGNOSIS; DIAGNOSIS; DRUG INTERMITTENT THERAPY; EXPERT WITNESS; FATALITY; HINDSIGHT BIAS; HUMAN; INCIDENTAL FINDING; INCIDENTALOMA; IONIZING RADIATION; LUNG CALCIFICATION; LUNG CARCINOMA; LUNG GRANULOMA; LUNG NODULE; LUNG NON SMALL CELL CANCER; MALPRACTICE; MEDICAL DECISION MAKING; MEDICOLEGAL ASPECT; NEGLIGENCE; OUTCOME BIAS; OVERDIAGNOSIS; PARANASAL SINUS; PATIENT INFORMATION; PREVALENCE; PRIORITY JOURNAL; RADIATION EXPOSURE; RADIOLOGIST; REPEAT PROCEDURE; REVIEW; TERATOMA; THORAX RADIOGRAPHY;

AGED; AGED, 80 AND OVER; DENTIGEROUS CYST; DIAGNOSTIC ERRORS; FATAL OUTCOME; FEMALE; HUMANS; INCIDENTAL FINDINGS; LUNG NEOPLASMS; MALPRACTICE; MIDDLE AGED; PREVALENCE; RADIATION DOSAGE; TOMOGRAPHY, X-RAY COMPUTED;

EID: 79951570038     PISSN: 00338389     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.rcl.2010.11.002     Document Type: Review

References (45)

1. Brant W.E., Helms C.A. Fundamentals of diagnostic radiology 1994, Williams & Wilkins, Baltimore (MD), p. 483.
2. Juhl J.H., Crummy A.B., Kuhlman J.E. Essentials of radiologic imaging 1998, Lippincott-Raven, Philadelphia, p. 787.
3. Schloendorff v The Society of New York Hosp, 105 NE 92 (NY 1914).
4. Duckworth v Lutheran Med Ctr 1995 WL 33070, (OH App.1995).
5. Berlin L. Failure to diagnose lung cancer: anatomy of a malpractice trial. AJR Am J Roentgenol 2003, 180:37-45.
6. Werth B. Damages 1998, Simon & Schuster, New York, p. 54.
7. Berlin L. Hindsight bias. AJR Am J Roentgenol 2000, 175:597-601.
8. Berlin L. Outcome bias. AJR Am J Roentgenol 2004, 183:557-560.
9. Cronan J.J. Thyroid nodules: is it time to turn off the US machines?. Radiology 2008, 247:602-604.
10. Shirodkar M., Jabbour S.A. Endocrine incidentalomas. Int J Clin Pract 2008, 62:1423-1431.
11. Song J.H., Chaudhry F.S., Mayo-Smith W.W. The incidental adrenal mass on CT: prevalence of adrenal disease in 1049 consecutive adrenal masses in patients with no known malignancy. AJR Am J Roentgenol 2008, 190:1163-1168.
12. Berland L.L. Incidental extracolonic findings on CT colonography: the impending deluge and its implications. J Am Coll Radiol 2009, 6:14-20.
13. MacMahon H., Austin J.H.M., Gamsu G., et al. Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society. Radiology 2005, 237:395-400.
14. Ravenel J.G., Costello P., Silvestri G.A. Screening for lung cancer. AJR Am J Roentgenol 2008, 190:755-761.
15. Croswell J.M., Baker S.G., Marcus P.M., et al. Cumulative incidence of false-positive test results in lung cancer screening: a randomized trial. Ann Intern Med 2010, 152:505-512.
16. Warshauer D.M. The age of (over) discovery. J Am Coll Radiol 2010, 7:246-247.
17. Welch H.G., Black W.C. Overdiagnosis in cancer. J Natl Cancer Inst 2010, 102:605-613.
18. Casarella W.J. A patient's viewpoint on a current controversy. Radiology 2002, 224:927.
19. Esserman L., Thompson I. Solving the overdiagnosis dilemma. J Natl Cancer Inst 2010, 102:582-583.
20. Ginsberg L.E. " If clinically indicated:" is it?. Radiology 2010, 254:324-325.
21. Berland L.L. Incidentalomas on CT colonography: do not make a mountain out of a molehill. J Am Coll Radiol 2009, 6:599-600. [author's reply].
22. Fletcher R.H., Pignone M. Extracolonic findings with computed tomographic colonography: asset or liability?. Arch Intern Med 2008, 168:685-686.
23. Epstein R.M., Korones D.N., Quill T.E. Withholding information from patients: when less is more. N Engl J Med 2010, 362:380-381.
24. Schreiber M.H., Leonard M., Rieniets C.Y. Disclosure of imaging findings to patients directly by radiologists: survey of patients' preferences. AJR Am J Roentgenol 1995, 165:467-469.
25. Jordan H. No such thing as a bad day 2000, Longstreet Press, Atlanta (GA), p. 153.
26. Kolata G. Sick and scared, and waiting, waiting, waiting. New York Times August 20, 2005, A1.
27. Angier N. Ultrasound and fury: one mother's ordeal. New York Times November 26, 1996, Available at:, Accessed May 24, 2010. http://www.nytimes.com/1996/11/26/science/ultrasound-and-fury-one-mother-s-ordeal.html.
28. Angier N. Doctors favor ultrasound use in right hands. New York Times July 15, 1997, Available at:, Accessed May 24, 2010. http://www.nytimes.com/1997/07/15/science/doctors-favor-ultrasound-use-in-right-hands.html.
29. Filly R.A. Obstetrical sonography: the best way to terrify a pregnant woman [editorial]. J Ultrasound Med 2000, 19:1-5.
30. Picoult J. Handle with care 2009, Simon & Schuster, New York, p. 337.
31. American Medical Association Council on ethical and judicial affairs. Code of medical ethics 2008-2009 Edition; 8. 08, Informed Consent 2008:245-6.
32. Cancer screening and the individual [editorial]. New York Times April 14, 2002, A12.
33. Schwartz L.M., Woloshin S., Fowler F.J., et al. Enthusiasm for cancer screening in the United States. JAMA 2004, 291:71-78.
34. Domenighetti G., D'Avanzo B., Egger M., et al. Women's perception of the benefits of mammography screening: population-based survey in four countries. Int J Epidemiol 2003, 32:816-821.
35. Lafata J.E., Simpkins J., Lamerato L., et al. The economic impact of false-positive cancer screens. Cancer Epidemiol Biomarkers Prev 2004, 13:2116-2132.
36. Lester W. Jurors say they follow beliefs, not instructions. Chicago Sun Times October 24, 1998, 37.
37. Schauer D.A., Linton O.W. National council on radiation protection and measurements report shows substantial medical exposure increase. Radiology 2009, 253:293-296.
38. Brenner D.J. Medical imaging in the 21st century: getting the best bang for the rad. N Engl J Med 2010, 362:943-945.
39. deGonzalez A.B., Mahadevappa M., Kim K.P., et al. Projected cancer risks from computed tomographic scans performed in the United States in 2007. Arch Intern Med 2009, 169:2071-2077.
40. Sternberg S. Unnecessary CT scans exposing patients to excessive radiation. USA Today November 29, 2007, A1.
41. Redberg R.F. Cancer risks and radiation exposure from computed tomographic scans: how can we be sure the benefits outweigh the risks?. Arch Intern Med 2009, 169:2049-2050.
42. Kohane I.S., Masys D.R., Altman R.B. The incidentaloma: a threat to genomic medicine. JAMA 2006, 296:212-215.
43. Wolf S.M., Kahn J.P., Nelson C.A. The incidentaloma. JAMA 2006, 296:2800-2801. [letters].
44. Tarini B.A. The current revolution in newborn screening: new technology, old controversies. Arch Pediatr Adolesc Med 2007, 161(8):767-772.
45. Rangel E.K. The management of incidental findings in neuro-imaging research: framework and recommendations. J Law Med Ethics 2010, 38(1):117-126.