Second-opinion interpretation of outside facility general ultrasound studies: rate of discrepancies and management change.

BACKGROUND

Second-opinion reads on imaging studies are common for CT and MRI, but many institutions are hesitant to implement a workflow for second read of ultrasound studies performed at other facilities due to quality considerations.

OBJECTIVE

The purpose of this study was to assess discrepancy rates between initial and second-opinion general ultrasound reports METHODS: We reviewed all requests of second-opinion US studies referred to our tertiary care center between 02/01/2020 and 06/23/2022. We evaluated percentage of exams that were interpreted versus archived. Whenever the original report was available (n = 196 studies), we evaluated any discrepancy in findings, interpretation, and potential management change based on second report compared to the initial report as evaluated by consensus agreement of 3 subspecialized radiologists.

RESULTS

A total of 586 ultrasound studies for 533 patients were nominated for consult. After excluding 58 studies for technical reasons (e.g., duplicate nomination, images for procedure guidance, modality is not ultrasound) and 282 studies that were archived by the reading radiologist due to various objective (e.g., studies such as echocardiography not interpreted by the abdominal imagers or more recent study available obviating need for consultation) and subjective (e.g., suboptimal image quality, lack of cine clips) reasons, a total of 246 studies were reinterpreted and were further analyzed. Only 21/246 patients (8.5%) got repeat ultrasound of the same body part within 3 months of original study date. The original (first-read) report was available for 196/246 studies, with discrepancy present between the first and second reads in 74/196 (37.8%) studies, with potential management change in 51/196 (26.0%) studies.

CONCLUSION

Second-opinion interpretation of outside ultrasound examinations by subspecialized radiologists can result in recommended management change in 26% of studies indicating potential for added value to reinterpreting ultrasound studies despite the concerns for quality control.