Second-opinion interpretations of gynecologic oncologic MRI examinations by sub-specialized radiologists influence patient care Journal Article


Authors: Lakhman, Y.; D'Anastasi, M.; Miccò, M.; Scelzo, C.; Vargas, H. A.; Nougaret, S.; Sosa, R. E.; Chi, D. S.; Abu-Rustum, N. R.; Hricak, H.; Sala, E.
Article Title: Second-opinion interpretations of gynecologic oncologic MRI examinations by sub-specialized radiologists influence patient care
Abstract: To determine if second-opinion review of gynaecologic oncologic (GynOnc) magnetic resonance imaging (MRI) by sub-specialized radiologists impacts patient care. 469 second-opinion MRI interpretations rendered by GynOnc radiologists were retrospectively compared to the initial outside reports. Two gynaecologic surgeons, blinded to the reports' origins, reviewed all cases with discrepancies between initial and second-opinion MRI reports and recorded whether these discrepancies would have led to a change in patient management defined as a change in treatment approach, counselling, or referral. Histopathology or minimum 6-month imaging follow-up were used to establish the diagnosis. Second-opinion review of GynOnc MRIs would theoretically have affected management in 94/469 (20 %) and 101/469 (21.5 %) patients for surgeons 1 and 2, respectively. Specifically, second-opinion review would have theoretically altered treatment approach in 71/469 (15.1 %) and 60/469 (12.8 %) patients for surgeons 1 and 2, respectively. According to surgeons 1 and 2, these treatment changes would have prevented unnecessary surgery in 35 (7.5 %) and 31 (6.6 %) patients, respectively, and changed surgical procedure type/extent in 19 (4.1 %) and 12 (2.5 %) patients, respectively. Second-opinion interpretations were correct in 103 (83 %) of 124 cases with clinically relevant discrepancies between initial and second-opinion reports. Expert second-opinion review of GynOnc MRI influences patient care. aEuro cent Outside gynaecologic oncologic MRI examinations are often submitted for a second-opinion review. aEuro cent One-fifth of MRIs had important discrepancies between initial and second-opinion interpretations. aEuro cent Second-opinion review of gynaecologic oncologic MRI is a valuable clinical service.
Keywords: magnetic resonance imaging; endometrial cancer; management; trachelectomy; neuroradiology; health-care; body ct; myometrial invasion; opinion; second; ct scans; cancer; gynaecologic oncologic imaging; subspecialty radiologists; early cervical-carcinoma; reinterpretation
Journal Title: European Radiology
Volume: 26
Issue: 7
ISSN: 0938-7994
Publisher: Springer  
Date Published: 2016-07-01
Start Page: 2089
End Page: 2098
Language: English
ACCESSION: WOS:000377996200014
DOI: 10.1007/s00330-015-4040-5
PROVIDER: wos
PUBMED: 26494640
PMCID: PMC5527327
Notes: Article -- Source: Wos
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MSK Authors
  1. Yuliya Lakhman
    34 Lakhman
  2. Evis Sala
    95 Sala
  3. Dennis S Chi
    496 Chi
  4. Hedvig Hricak
    333 Hricak
  5. Ramon Elias Sosa
    16 Sosa