The 'incidentalomas' and the medical imaging : looking, knowing ? ; Les 'incidentalomes' et l'imagerie médicale : voir, savoir ?

Context: The technical processes of medical imaging are guarantees for the clinician who faces the opacity of the body. Thus, medical imaging pierces the darkness of the flesh to search for invisible injuries. This research implies the creation of new data that sometimes has no correlation with clinical symptoms or the reasons of the search. In 1982, these unexpected or fortuitous discoveries gave rise to the invention of a neologism, "incidentaloma", which seems to crystallize the questions of clinicians on fortuitous discoveries made by radiologists. However, there does not seem to have a precise definition for this new term. How did a term without a consensual definition spread in the medical literature? Do radiologists, endocrinologists and surgeons use this term? Is there an echo of this term in certain fields of medicine also impacted by the problem of incidental findings such as genetics for example? Is this term a sign that our medical system is based on the principle "see everything and know everything" that focuses above all on quantifiable data generated by advanced technological equipment? Method: After an initial observation in the radiology department of the Hôpital Européen Georges Pompidou (HEGP), radiological practices based on the existing scientific and medical literature, a retrospective study of patients' files with abdominal incidental finding, and a nationwide survey aimed at radiologists. Results: When reviewing the scientific and medical literature, it appears that despite the large number of publications using the term "incidentaloma", there does not seem to have a precise or consensual definition. The review of electronic patient records shows that neither the term "incidentaloma" nor the term "incidental finding" are used in the reports to describe these findings. Radiologists who took part in the survey acknowledged that when confronted with incidental findings they faced uncertainty on the etiology and seriousness. It raised the question of patient information. Conclusions: ...