Question

My father recently had an MRI done because he was in a car accident and fractured his pelvis. The radiologist reading the MRI noted there was a nodule in his lung and one in his liver. He told my father to check back in 3 months for a repeat MRI. Does this seem too long to wait? My father doesn't smoke or drink at all.

Answer

Your father's situation (that of an incidental finding) is becoming increasingly common as our diagnostic tools become more sensitive to even very small abnormalities. New tools such as MRI scans can find tiny abnormalities that would never have been seen by X-ray or even CAT scan. This can give us a head start on diagnosing a condition earlier than we could in the past and possibly increase the chances of successful treatment. On the negative side, if a harmless abnormality is found it can lead to unnecessary worry, unnecessary diagnostic tests and, even worse, can lead to biopsies or treatments that are potentially dangerous. So, it's important that the physician gauge the risks that the abnormality represents a truly pathologic process. He does this by considering the patient's risk factors, the patient's symptoms, the physical exam, lab tests and the characteristics of the radiological finding. If he feels that the risks are high, then it's likely that further tests, such as a biopsy, will be ordered. If the risk seems low, then a repeat test in a few months is done to ensure that the lesion hasn't grown.

Only your father's physician, after consulting with the radiologist, has all the information necessary to decide if immediate testing is warranted, rather than a less aggressive approach, i.e. repeating the exams later.