Interpreting urgent brain CT scans: Does review by a radiology trainee make a difference in accuracy?

An urgent brain CT scan is now commonly performed on patients presenting to hospital emergency departments for a wide variety of indications. At most institutions in Australia, such scans are reviewed immediately by an on-call radiologist, who is usually an accredited registrar. The value of the trainee radiologist in such a setting is unclear. In the present study, the rate of abnormal findings in a random sample of 100 brain CT scans performed on hospital patients is reviewed and the accuracy of detection of potentially urgent lesions is compared between three junior clinicians, an accredited radiology registrar and a junior radiographer, using the final radiological report as the standard of reference. At least one potentially urgent abnormality in 25% of the patients scanned was found. The RANZCR trainee recorded a significantly higher sensitivity compared to the other readers. It is concluded that an urgent brain CT is of greater value as a screening test if a contemporaneous radiological review is made available, and the implications this may have on current imaging practices are briefly considered.