Second-Opinion Interpretations of Gynecologic Oncologic MRI Examinations by Sub-Specialized Radiologists Influence Patient Care

Lakhman, Yulia; D’Anastasi, Melvin; Miccò, Maura; Scelzo, Chiara; Vargas, Hebert Alberto; Nougaret, Stéphanie; Sosa, Ramon E.; Dennis, S.; Abu‐Rustum, Nadeem R.; Hricak, Hedvig; Sala, Evis

doi:10.1007/s00330-015-4040-5

Cited by 49 publications

(27 citation statements)

References 33 publications

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“…These findings add to the existing literature demonstrating that reinterpretation of imaging studies by subspecialty radiologists in different fields (eg, pediatric imaging, emergency radiology, and neuroradiology) has a positive impact on patient care . Our findings are also in agreement with studies from tertiary cancer centers concluding that reinterpretation by radiologists specialized in oncologic imaging has a clinically important effect on the accuracy of cancer patient staging, prognostication, and management . The rates of clinically important or major discrepancies between reports in these studies range from 1.2% to 40%.…”

Section: Discussionsupporting

confidence: 88%

“…[10][11][12][13][14] Our findings are also in agreement with studies from tertiary cancer centers concluding that reinterpretation by radiologists specialized in oncologic imaging has a clinically important effect on the accuracy of cancer patient staging, prognostication, and management. [15][16][17][18][19] The rates of clinically important or major discrepancies between reports in these studies range from 1.2% to 40%. A direct comparison of these data with our 15% rate of clinically important discrepancies is difficult because of inherent differences between subspecialties, variability in the types and mix of cases reviewed, and variances in how clinical importance was determined.…”

Section: Discussionmentioning

confidence: 99%

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Second‐opinion interpretations of neuroimaging studies by oncologic neuroradiologists can help reduce errors in cancer care

Hatzoglou

Omuro

Haque

et al. 2016

Cancer

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Background The purpose of this study was to investigate the utility and clinical impact of second-opinion interpretations of outside neuroimaging studies by oncologic neuroradiologists at an NCI-designated cancer center. Methods We performed a retrospective analysis of initial outside and second-opinion radiology reports from 300 CT and MRI neuroimaging studies and identified cases with discrepancies between the two reports. An adult neuro-oncologist, pediatric neuro-oncologist, and head and neck surgeon reviewed each pair of discrepant reports based on their area of expertise, patient age, and type of study performed. The clinicians were blinded to the origin of each report and recorded whether the differences in the reports would have led to a change in patient management and/or disease staging. Histopathologic analysis, clinical assessment, and/or minimum 3-month imaging follow-up served as the reference standards to establish which of the 2 reports were correct. Results Among the 283 cases that met our study criteria, there were 55 neuroimaging studies with disagreements (19%) between the initial outside report and second-opinion interpretation. Patient management and/or disease stage would have been altered in 42 of 283 cases (15%) based on report differences as determined by the 2 neuro-oncologists and surgeon participating in the study. Sufficient follow-up was available in 35 of 42 cases (83%). The second-opinion interpretation was correct 100% of the time (35/35). Conclusion Second-opinion interpretations of neuroimaging studies by subspecialized oncologic neuroradiologists provide added value by reducing error and optimizing the care of cancer patients.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Second‐opinion interpretations of neuroimaging studies by oncologic neuroradiologists can help reduce errors in cancer care

Hatzoglou

Omuro

Haque

et al. 2016

Cancer

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“…When clinically indicated, follow-up CT and PET CT imaging are valuable tools that help in the early detection of recurrent disease that may be amenable to surgical resection. Recent data show that radiology review by a radiologist who specializes in gynecology can change management in 20–21.5% of cases [34]. …”

Section: Where Do We Go From Here?mentioning

confidence: 99%

Is It Time to Centralize Ovarian Cancer Care in the United States?

et al. 2015

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Purpose The purpose of this article is to broadly review the most up-to-date information pertaining to the centralization of ovarian cancer care in the United States and worldwide. Methods Much of the present literature pertaining to disparities in and centralization of ovarian cancer care in the United States and internationally was reviewed and included, specifically, original research and review articles. Results Data show improved optimal debulking rates, NCCN guideline adherence, and overall survival rates in higher volume, more specialized hospitals and amongst higher volume providers. Conclusion Patients with invasive epithelial ovarian cancer, especially those with higher stages (III and IV), are better served by centralized care in high-volume hospitals, by high-volume physicians, who adhere to NCCN guidelines wherever possible. More research is needed to determine the policy changes that can increase NCCN guideline adherence in low-volume hospitals and in low-provider caseload scenarios. Policy and future research should be aimed at increasing patient access, either directly or indirectly, to high-volume hospital and high-volume providers, especially amongst Medicare, lower socioeconomic status, and minority patients.

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“…In many centres, consultation and second-opinion interpretation of medical images by subspecialty radiologists are routinely performed [8][9][10][11][12]. Therefore, the purpose of this study is to evaluate the increased detection of focal lesions and other radiological findings of subspecialty second-opinion (SSO) consultations for CT examinations in MM patients undergoing stem cell transplantation on standard computed tomography.…”

Section: Introductionmentioning

confidence: 99%

Subspecialty Second-Opinion in Multiple Myeloma CT: Emphasis on Clinically Significant Lytic Lesions

et al. 2020

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Background and objectives: In order to increase the accuracy of lytic lesion detection in multiple myeloma, a dedicated second-opinion interpretation of medical images performed by subspecialty musculoskeletal radiologists could increase accuracy. Therefore, the purpose of this study is to evaluate the added value (increased accuracy) of subspecialty second-opinion (SSO) consultations for Computed Tomography (CT) examinations in Multiple Myeloma (MM) patients undergoing stem cell transplantation on standard computed tomography with a focus on focal lesion detection. Materials and Methods: Approval from the institutional review board was obtained. This retrospective study included 70 MM consecutive patients (mean age, 62 years ± 11.3 (standard deviation); range, 35–88 years) admitted in the last six years. Pre-transplant total-body CT (reported by general radiologists) was the only inclusion criteria. Each of these CT examinations had a second-opinion interpretation by two experienced subspecialty musculoskeletal (MSK) radiologists (13 years of experience and 6 years of experience, mean: 9.5 years), experts in musculoskeletal radiology and bone image interpretation with a focus on lytic lesions. Results: Per lesion intra- and inter-observer agreement between the two radiologists was calculated with K statistics and the results were good (K = 0.67: Confidence Inteval (CI) 95%: 0.61–0.78). When the initial CT reports were compared with the re-interpretation reports, 46 (65%) of the 70 cases (95% CI: 37–75%) had no discrepancy. There was a discrepancy in detecting a clinically unimportant abnormality in 10/70 (14%) patients (95% CI: 7–25%) unlikely to alter patient care or irrelevant to further clinical management. A discrepancy in interpreting a clinically important abnormality was registered in 14/70 (21%) patients for focal lesions. The mean diameter of focal lesions was: 23 mm (95% CI: 5–57 mm). The mean number of focal lesions per patient was 3.4 (95% CI). Conclusions: subspecialty second-opinion consultations in multiple myeloma CT is more accurate to identify lesions, especially lytic lesions, amenable to influence patients’ care.

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Second-Opinion Interpretations of Gynecologic Oncologic MRI Examinations by Sub-Specialized Radiologists Influence Patient Care

Cited by 49 publications

References 33 publications

Second‐opinion interpretations of neuroimaging studies by oncologic neuroradiologists can help reduce errors in cancer care

Second‐opinion interpretations of neuroimaging studies by oncologic neuroradiologists can help reduce errors in cancer care

Is It Time to Centralize Ovarian Cancer Care in the United States?

Subspecialty Second-Opinion in Multiple Myeloma CT: Emphasis on Clinically Significant Lytic Lesions

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