"Blind spots" in the analysis of computed tomography of the head and neck area

Abstract

Background: In radiology diagnostic errors occur in 2–5% of cases and most of them are due to perception errors, when a pathology don’t detected during the initial analysis, although its presence is very obvious during a retrospective analysis. In some cases, their appearance is associated with the presence of “blind spots” - anatomical areas that most often go unnoticed when interpreted by a radiologist. It is extremely important to know their features when analyzing the study of the head and neck area for a targeted and systematic search for pathology.
 
 
 Aims: determine the most common anatomical areas in which radiologists do not describe pathological changes when analyzing computed tomograms of the head and neck area.
 
 
 Methods: retrospectively analyzed 64 CT scans of the head and neck region in cancer patients, in which there was no description of additional clinically significant pathological changes at the initial assessment. All cases of missed pathology were identified after repeat radiological examination or retrospective analysis of the study.
 
 
 Results: Several anatomical zones were identified in which the most common pathological findings were not described in the initial analysis of CT studies of the head and neck area: brachiocephalic vessels (n=15; 24,2%), parotid salivary glands (n=10; 16,1% ), paranasal sinuses (n=8; 12,9%), lungs and mediastinum (n=9; 14,6%), brain and temporal bones (n=5; 8,1%), soft tissues of the neck (n =4; 6,5%), thyroid gland and cervical spine (n=3; 4,8%).
 
 
 Conclusions: the most common “blind spots” in the analysis of CT scans of the head and neck region have been identified. Knowledge of them can potentially lead to a reduction in the incidence of missed pathology when interpreting an CT study of this anatomical location.