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Strategies for Avoiding Recommendations for Additional Imaging Through a Comprehensive Comparison With Prior Studies.

Ankur M Doshi1, Michael Kiritsy1, Andrew B Rosenkrantz1

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A small percentage of imaging recommendations can be avoided by reviewing all prior scans. Comprehensive comparison of imaging, including different modalities and body areas, is crucial for accurate interpretation and avoiding unnecessary follow-up imaging.

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Area of Science:

  • Radiology
  • Medical Imaging Analysis

Background:

  • Recommendations for additional imaging and/or intervention (RAIs) are common in abdominal CT and MRI reports.
  • Incomplete review of prior imaging may lead to unnecessary RAIs.

Purpose of the Study:

  • To determine the frequency of avoidable RAIs in abdominal CT and MRI.
  • To characterize the nature of these avoidable RAIs.

Main Methods:

  • Retrospective evaluation of 1,006 RAIs in abdominopelvic CT and MRI reports.
  • Review of all available prior imaging examinations for each patient to identify avoidable RAIs.

Main Results:

  • 4.1% of RAIs were found to be avoidable.
  • Avoidable RAIs were often linked to prior chest imaging or different modalities.
  • In nearly half of avoidable RAIs, the key finding was present but unreported in prior studies.

Conclusions:

  • Thorough review of all prior imaging, including different modalities and body parts, can reduce RAIs.
  • Direct image review is essential, especially for upper abdominal findings.
  • PACS optimization could aid in comparing relevant prior examinations.