Abstract
Radiological error is inevitable and usually multifactorial. Error can be secondary to radiologist-specific causes, including cognitive and perceptive errors or ambiguity of report, or system-related causes, including inadequate, misleading, or incorrect clinical information, poor imaging technique, excessive workload, and poor working conditions. In this paper, we discuss a systematic approach to reduce errors in oncological radiology reporting, thus reducing risk to the patient. Rather than attempt to discuss all types of error, we concentrate on the most important and commonly occurring errors that we have encountered over 20 years of practice, based on weekly discrepancy reviews of our practice and independent reviews of clinical and research imaging from other institutions. This review focuses on computed tomography (CT) reporting for staging, surveillance, and response assessment of cancer patients, but the messages apply to all imaging methods.
Highlights
Mistakes in the interpretation of medical images are common and probably inevitable 1
We aim to discuss the most common and clinically important CT reporting errors 6. These have been identified through 20 years of experience at weekly discrepancy review meetings in a cancer centre, managing clinical trials and providing independent imaging reviews for other hospitals and outside agencies, such as the European Organisation for Research and Treatment of Cancer (EORTC) and Cancer Research UK (CRUK)
Advanced cancer patients have a high chance of developing complications that can be successfully ameliorated, improving their quality of life
Summary
Mistakes in the interpretation of medical images are common and probably inevitable 1. Spotting an early lung metastasis may spare the patient unnecessary debilitating radical surgery We recognise these issues can occur anywhere, but give 5 rules to avoid most mistakes: 1: Adjust Window Levels and Centres 7: In the days of “hard copy” printed film, a culture developed of soft tissue and lung windows to view CT. Viewing “bone windows” required queuing up to use the workstation and could not be done for imported films It is surprising in the modern PACS era that we still see reporters relying on a single soft tissue window to review the whole body viscera. 2: Review the lungs using Maximum Intensity Projections (MIPs): These MIPs are created using thick slices with small inter-slice increments e.g. 8 mm on 1 mm increments This approach is as old as spiral CT itself 12 but keeps needing to be re-advertised 13. Our advice is the reporter should have a good reason not to do this in any case
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
