Followup imaging after urological imaging studies: comparison of radiologist recommendation and urologist practice

We determined if differences in the perceived need for followup imaging between an ordering urologist and the interpreting radiologist have an impact on the use of imaging technology for urological conditions.

Consecutive radiology reports for 985 patients were retrospectively reviewed in 2 urological practices. Imaging included computerized tomography, magnetic resonance imaging, ultrasonography and excretory urography. All imaging reports were analyzed for the radiologist recommendation for followup imaging and correlated with subsequent studies ordered by the urologist within 6 months of the original study.

Radiologists recommended followup studies in 202 of 985 reports (20.5%). A followup study was actually ordered for 65 of these 202 patients (32.2%). Urologists ordered studies for 87 of 783 (11.1%) patients for whom the radiologist did not make a recommendation. Overall urologists ordered followup studies for 152 of 985 patients (15.4%) or 24.8% fewer studies than recommended by the radiologist.

There is a significant reduction in imaging use when urologists evaluate radiologist recommendations and then direct followup imaging.