Virarkar Mayur, Jensen Corey, Klekers Albert, Wagner-Bartak Nicolaus A, Devine Catherine E, Lano Elizabeth A, Sun Jia, Tharakeswara Bathala, Bhosale Priya
Department of Radiology, University of Florida College of Medicine, Jacksonville, FL, United States of America.
Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
Clin Imaging. 2022 Jun;86:13-19. doi: 10.1016/j.clinimag.2022.03.014. Epub 2022 Mar 17.
The purpose of this retrospective study was to evaluate the quality of outside hospital imaging and associated reports submitted to us for reinterpretation related to clinical care at our tertiary cancer center. We compared the initial study interpretations to that of interpretations performed by subspecialty-trained abdominal radiologists at our center and whether this resulted in a change in inpatient treatment.
We performed an institutional review board-approved retrospective single-institution study of 915 consecutive outside computed tomography (CT) and magnetic resonance (MR) abdominal imaging studies that had been submitted to our institution between August 1, 2020 and November 30, 2020. The assessed parameters included the quality and accuracy of the report, the technical quality of the imaging compared to that at our institution, the appropriateness of the imaging for staging or restaging, usage of oral and IV contrast, and CT slice thickness. Clinical notes, pathologic findings, and subsequent imaging were used to establish an accurate diagnosis and determine the effect on clinical treatment. Discrepancies between the initial and secondary interpretations were identified independently by a panel of radiologists to assess changes in treatment. The impact of discrepancies on treatment was evaluated based on current treatment guidelines.
Of 744 CT (81%) and 171 MR (19%) outside imaging studies, 65% had suboptimal quality compared to the images at our institution, and 31% were inappropriate for oncological care purposes. Only 21% of CT studies had optimal slice thickness of <3 mm. Of 375 (41%) outside reports, 131 (34%) had discrepancies between secondary and initial interpretations. Of the 88 confirmed discrepant studies, 42 patients (48%) had a change in treatment based on the secondary interpretation.
Imaging studies from outside institutions have variable image quality and are often inadequate for oncologic imaging. The secondary interpretations by subspecialty-trained radiologists resulted in treatment change.
本回顾性研究旨在评估提交至我们三级癌症中心进行与临床护理相关重新解读的外院影像检查及相关报告的质量。我们将初始研究解读与我们中心经亚专业培训的腹部放射科医生所做的解读进行比较，并探讨这是否导致住院治疗的改变。
我们进行了一项经机构审查委员会批准的回顾性单机构研究，研究对象为2020年8月1日至2020年11月30日期间提交至我们机构的915例连续的外院腹部计算机断层扫描（CT）和磁共振（MR）影像检查。评估参数包括报告的质量和准确性、与我们机构相比影像的技术质量、影像用于分期或再分期的适宜性、口服和静脉造影剂的使用情况以及CT切片厚度。临床记录、病理结果和后续影像用于确立准确诊断并确定对临床治疗的影响。由一组放射科医生独立识别初始解读和二次解读之间的差异，以评估治疗的变化。根据当前治疗指南评估差异对治疗的影响。
在744例（81%）CT和171例（19%）外院影像检查中，与我们机构的影像相比，65%的质量欠佳，31%不适用于肿瘤护理目的。只有21%的CT研究具有小于3毫米的最佳切片厚度。在375份（41%）外院报告中，131份（34%）在二次解读和初始解读之间存在差异。在88例经确认的有差异研究中，42例患者（48%）基于二次解读改变了治疗方案。
外院机构的影像检查图像质量参差不齐，通常不足以用于肿瘤影像检查。经亚专业培训的放射科医生进行的二次解读导致了治疗改变。
