Concurrent Chest and Abdominal CT: Managing Pitfalls of Splitting Interpretation by Subspecialty

Area of Science:

• Radiology
• Medical Imaging
• Diagnostic Imaging

Background:

• Concurrent chest and abdominal CT scans are often interpreted by separate radiologists.
• This division of labor presents unique challenges and potential errors in interpretation.

Purpose of the Study:

• To identify and discuss potential pitfalls in the dual-reader interpretation of concurrent chest and abdominal CT examinations.
• To provide strategies for mitigating these interpretation challenges in clinical practice.

Main Methods:

• Review of example cases illustrating interpretation pitfalls.
• Discussion of mitigation strategies including search pattern modification, guideline establishment, and inter-reader communication.

Main Results:

• Identified pitfalls include contrast timing discrepancies, lesions crossing anatomical boundaries, and unclear secondary reader responsibilities.
• Demonstrated cases of pancreatic adenocarcinoma on chest CT, pulmonary embolism on abdominal CT, and metastatic GIST invading the chest.

Conclusions:

• Recognizing and addressing specific pitfalls in dual-reader interpretation of chest and abdominal CT is crucial.
• Implementing modified search patterns, clear guidelines, and enhanced communication can improve diagnostic accuracy and patient care.