What Percent Of Radiology Studies Are Not Correct For One Reason Or Another? Up to 30%…

How Radiology Errors Occur When radiology errors occur, they may not be caused by a failure of just one part of the imaging procedure. Instead, these errors could result from a variety of issues, including: Misread scans, images or X-rays Errors in filing the imaging test results properly to guarantee they remain associated with the right patient Miscommunication between several pathologists, lab technicians, and radiologists What You Should Consider Diagnostic error rates are now thought to be as high as 30 %. Having another look at your diagnostic study should be mandatory, especially with serious medical problems facing the patient. Many times there are discrepancies that can easily be resolved such as motion artifact, meaning that the patient moved during an MRI study and that made it difficult for the reading radiologist to interpret the study. That motion artifact can be resolved by having the test run again, and the patient not moving. But there are also more serious problems when a radiologist may not be trained to recognize a serious issue because they do not have all of the training and advanced training needed to diagnose the condition. That is why it is always recommended that a patient ask to see the radiologist’s background, including all advanced Fellowship sub-specialty training. There are many times where a general radiologist has enough information to make a proper diagnosis, but it is in the case of highly technical scans that the need for a neuro-radiologist or a musculoskeletal (MSK) radiologist, or a body radiologist, or an advanced radiologist with a specialty in cardiology, is necessary. Second Reading Offers Transparency There is also ample evidence that double reading a study improves accuracy. In the case of radiology, the concept of double reading can be very effective in having another radiologist read a study for a second time, offering a 2nd look or 2nd opinion. Double reading is one of the best ways to safeguard the quality of service to have a significant impact on the maintenance of quality. It is the job of the radiologist to read the study and issue a report correctly. No one is infallible, and mistakes can and will be made, especially in an area of medicine (radiology) that is so dependent on personal medical interpretation. Errors due to wrong interpretation can lead to the wrong diagnosis. The image or the x-ray that was taken is vital to the patient and the radiologist. This is considered raw data and data is to be analyzed effectively so the expert in the field of radiology must have enough learning or skills in the field and have sharp reasoning skills to be able to produce the proper diagnosis. Things to Consider A radiologist is usually highly trained. Always check to see what medical school and what advanced work the radiologist has in their background. Have they earned honors and graduated in the top 10% of their class? In the United States, medical professionals are held in very high regard if they are members of AOA (Alpha Omega Alpha) a highly skilled group of medical professionals who have graduated in the top 10% of their medical school. If a radiologist is trained in various subspecialties such as Breast, Brain, Body, MSK, Cardiology, there is a chance for a better outcome in reading an MRI, CT, PET, Nuclear Medicine, Ultra Sound, or an XRAY. You do want to improve your odds of a misread of up to 30% by utilizing a highly skilled second opinion for any significant and life changing imaging study.

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Do I need a 2nd Look for my MRI or any other imaging study?

Radiologists can overlook or make mistakes on a radiology study. Up to 30% of studies may have a problem associated with the diagnosis because of errors made during the test or during the study interpretation. Usually in just about every field of medicine, a second opinion for serious issues facing a loved one is warranted. Why not be sure? That applies especially to radiology studies such as an MRI, a CAT scan, a PET scan looking for cancer hot spots, a cardiology study and other studies as well. Better Safe than Sorry As with any aspect of life, the more we acquire knowledge and information, the more we gain confidence. As a patient, we have to make sure that we are making the right choices. We have to ensure the clarity of the test result and eliminate the risk of misdiagnosis. A second medical opinion or a second radiology opinion can catch errors that can have a profound effect in medical treatment and potential surgery. A second look or opinion can provide valuable information to make sure that you’re on the right track. These opinions can be a vital factor in your future well being. 3 Keys The number one key here is always to get an independent second look or opinion for any medical treatment and again that includes radiology. The second key is to make sure the radiologist reading your study is well advanced in the area of medicine pertaining to the condition. The third key is to look for a radiologist from a well-respected US medical school; a fellowship trained radiologist in a sub specialty that focuses on the condition. Give yourself and your family every opportunity to get this aspect of diagnosis correct!

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Were You Called Back for a Second Mammogram and Ultrasound?

Getting called back after a second mammogram and ultrasound is quite natural. It doesn’t mean that the second evaluation is the final result. Did you know that 2 in 20 women are being called back for more examination for additional evaluation? Doctors need to make sure that they focus on any suspicious areas or areas that did not produce good images. Being called back in your menopausal stage is also standard. What Else Could It Be? The following are the potential issues of getting called back after a mammogram or ultrasound: The images are not pure or didn’t show clear breast tissue and need a retake There is dense breast tissue that makes it hard to capture some areas of the breast The physician encounters calcifications, a cyst build up or a solid tumor The image quality might be low, or the file is corrupted In some cases, repeated mammograms can’t detect cancer because of the repeated x-ray on the area of the mass. Follow-Up Appointment The patient will probably be called back to take another mammogram test or a diagnostic Tomosynthesis or follow-up ultrasound. It is done to examine additional areas of the breast for comparison and other examination. The technician is guided by the radiologist to assure that the area of concern is clear.   You may also need to take another ultrasound test of the breast area.   Some patients may be required to have a breast MRI. During the procedure, you will be asked to lie face down in the MRI for 45 minutes to an hour. You’ll have to stay calm and still to produce detailed and clear images of your breast tissues. The procedure is painless. However, it can be uncomfortable for a patient who is claustrophobic. It is important to let your physician know prior to the test if you are anxious or uncomfortable in tight spaces. The following statements are likely to be the result of your screening: The suspicious area turned out to be okay, and you can now return to your regular schedule. There may be some follow-up needed especially if there is a history of breast cancer in the family.   The examined part of your breast tissue could be cancer, but will require a breast biopsy for further confirmation. A breast biopsy is a procedure by which a small portion of the breast tissue is taken for diagnostic purposes. Waiting for the result of your test could be quite frightening. Many patients can feel anxiety, fear, and sadness during the time. While waiting, here are the things that you have to remember: It is natural to feel this emotion Most of these follow-ups turn out to be benign and So most breast biopsies are not cancer

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When is a Cardiac MRI Needed?

Have you heard about Cardiac MRI or Cardiac Magnetic Resonance Imaging procedure?  The Cardiac MRI is a significant advancement in the medical field that is used by medical practitioners, radiologists and doctors to have a better grasp of what’s happening within the heart and around it. This is a procedure that is very reliable and accurate. It can show the physician how the heart functions and the structures around it. It can provide clear and detailed images of the anatomy of the heart. Who Needs To Undergo Cardiac MRI? Anyone who has a heart condition who needs to be monitored and checked can make use of this medical test and procedure. Whatever heart ailment you may have, cardiac MRI will be very helpful to help you monitor your condition. It is better than x-ray because it does not make use of radiation during the process. It is very safe and risk-free. It will take pictures of what is happening inside your body, specifically the heart. What Can a Cardiac MRI Identify and Show in the Results? The cardiac MRI can provide a very comprehensive and complete observation of your heart. It can allow your physician to view the valves, the chambers, and even the muscles of the heart so that your medical team can monitor if it is pumping correctly. The procedure can identify if the patient has the following: An occurrence of congenital or in-born heart diseases. Coronary damage from a heart attack. Heart valve damage due to age or related conditions. A healthy heart muscle after heart failure. What does an MRI Scan Involve? The MRI scanner is a huge machine with a large bore opening in the center. You will lie down on a table and slide inside. It could be a bit noisy, so technicians offer patients headphones, and they can listen to music while they are inside. You will be asked to hold your breath a few times during the test, so images can be taken while your chest is still. The scan could be as short as fifteen minutes or at least an hour, depending on the kind of issue being addressed. Is an MRI Scan Safe while Pregnant? There are no known dangers, but cardiologists normally do not recommend MRI in the first trimester, to be on the safe side. Is there anyone that this test would not be suitable for? A Cardiac MRI test might not be suitable for obese individuals, very claustrophobic patients or those with non-MRI compatible devices within the body. Check with your imaging facility. Considering the results that Cardiac MRI can provide, it can help the cardiologist to diagnose their patient accurately. The result will guide the cardiologist or the radiologist in providing the correct medical diagnosis and attention for the patient.

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What Is the Difference Between An MRI and A CAT Scan?

MRI MRI, or Magnetic Resonance Imaging, utilizes a highly sophisticated magnet and generates radio waves to scan the structures inside your body. Radiologist and other health professionals use this technology to examine and diagnose different conditions. Today, MRI is used for many conditions and complaints. Uses/Purposes MRI is utilized for the following conditions: Abnormalities in the spinal cord Brain anomalies Cysts, tumors and other irregularities in every part of the body Fractures and injuries of the joints, such as knee and hip Heart problems such as clogged arteries and internal bleeding Abnormalities in abdominal organs Examination of pelvic pain in women, endometriosis, and fibroids Infertility evaluation in women and other uterine abnormalities Preparation A patient who is about to undergo an MRI will be asked if they have any metal inside their body or any shrapnel or metallic foreign objects. That can include medical devices and accessories that contain metal. Remove all jewelry before your exam. If the patient is claustrophobic and has a fear of narrow spaces, they should tell ask doctor for medication prior to the scan, to help with claustrophobia and anxiety. The patient may be injected intravenously with a contrast agent to enhance the visibility of the subject part that is relevant to the evaluation. The patient should always check with their physician for any additional prep needed, the night before the test. The patient should always tell their imaging technician or nurse practitioner if they have any allergies to contrast agents.  The Nurse practitioner and technician will surely also ask the patient a series of questions pertaining to allergies. CAT Scan CAT, CT scan, also known as computed tomography scan, is a procedure that allows the radiologists to scan the body. A CAT is a specially designed computer that uses highly advanced XRAY imaging to produce images of your organs, tissues, and other parts of the body. Compared to a conventional X-ray, it creates a more detailed series of images. Again, the emphasis of using a high-speed CT is usually to examine patient’s organs, including the heart. Uses/Purposes The following are the uses and purposes of a CT scan: Used for detecting bone anomalies and joint problems such as complex skull fracture and tumors If you have heart disease, cancer, liver masses or emphysema, CAT scan is the medical device of choice A CT is used to show internal damage and bleeding The CT helps to locate infections, blood clots, tumors, and infections The CT is used as a guide for medication plans, biopsies, radiation therapies and surgeries Preparation Before the scan, you will be required not to drink or eat the night before the screening. It will also be necessary to remove all your accessories with metallic material, such as jewelry. During the test, you will be lying on a table surrounded by a doughnut-shaped CT machine. It is normal to experience a buzzing and whirring noise as the table gradually moves around you. Unnecessary movement can cause blurred images, so observe stillness and try to stay calm while inside the machine. MRI and CT scan are used for different purposes for different parts of the body. Your physician will determine which modality is best suited for your condition. Again there may be a dye contrast injection and you will be sked a series of questions regarding allergic symptoms especially towards Iodine based products. Please listen to the questions as they are very important in relationship to the injection of contrast.

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What is A CTA or CT Angiography?

CTA means Computed Tomography Angiography or CT Angiogram. It’s a procedure where X-rays are utilized to provide a detailed image of the heart, including the blood vessels, lungs, kidneys, brain, neck, arms, and legs. A CT Angiography displays the narrowed or the blocked areas of the blood vessels. This kind of test can also show if there is a swelling aneurysm or if there is a buildup of plaque in the blood vessels. CTA or CT Angiography is a painless and non-invasive test that allows high resolution, three-dimensional visualization of the heart, and other adjacent structures. This is a painless test because it is a scan. The CTA is used to detect or identify the weak section of the arteries or veins and to visualize the blood flow. It provides more precise images of the blood vessels than other types of tests such as MRI or ultrasound technology. Why Might You Need to Undergo This Kind of Test? If your doctor indicates that you have an abnormality, which involves your adjacent structures such as the blood vessels of your brain, lungs, kidneys, heart, the CT Angiography provides information for your physician to learn more about your condition. Here are some reasons to choose CT Angiography. They include the following: To find and identify aneurysm, a blood vessel that is bulging and is in danger of rupturing. To see the irregular formation of the blood vessels inside your brain. To identify damaged blood vessels caused by injuries. To find blood vessels that become narrowed because of atherosclerosis, the fatty material that builds-up plaque in the walls of the arteries. To find blood clots that may be formed inside your legs, which can enter your lungs. To evaluate if there is a tumor that is nourished by the blood vessels. What Are the Possible Risks that You Might Encounter for a Computed Tomography Angiography Test? In every test, there is always a slight risk of having a medical event during the procedure. There is always a bit of a risk for cancer due to repeated high exposure of radiation with numerous CTA, CT, or XRAY tests. But the advantages of getting a precise diagnosis generally outweigh the risks. The amount of radiation used during the CTA is minimal. Therefore, the risk of radiation exposure is minimal. Risks include: Allergic Reactions – Always tell your radiologist if you have a history of allergies or an allergy to contrast material. If you have allergies, you may start to take medicine before you take the CTA test. Tissue damage – If there is a large number of contrast materials, it can irritate your skin or your blood vessels and nerves under your skin. Once the test is completed, you will have your IV removed. In most situations, you can go back to your normal activities at home. You could be given some added instructions after the test, depending on your specific situation.

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What is 3D Tomosynthesis Mammography?

Tomosynthesis or 3D mammography is a new kind of digital x-ray mammogram that makes 3D- and 2D-like pictures of the breasts. This tool enhances the ability of mammography to spot early breast cancers and lowers the number of women called back for added tests for findings, which aren’t cancers. Types of Mammography There are two types of mammography which are Full Field Digital Mammography and 3 Dimensional Mammography, but this article will be focusing on 3D Tomosynthesis Mammography. 3D mammography, also known as “Digital Breast Tomosynthesis,” is a recommended process that uses an electronic detector system to produce multiple synthesized images of a thin layer of the breasts. In Tomosynthesis, the x-rays are being transferred into a high-resolution computerized monitor that allows the images to be viewed in a more narrow-angle. It enables the radiologist to examine digital images for comparison by laying one set of breast images over another. Tomosynthesis mammography produces 3-dimensional images of the breast. Usually, the images are composed of different structures such as fat, milk ducts, blood vessels, connective tissues, from various regions in the breast. Tomosynthesis acquires different angles with the help of sophisticated digital x-ray machinery. It also requires a paddle to compress the breast to secure it from unwanted motion. It mitigates the radiation and allows penetrating the breast tissue. When Tomosynthesis is added to digital mammography, it reveals an additional 1 to 2 cancers in every thousand women examined in the previous screening. Another study indicated that 2.5 percent of 1000 women ranging from 40-49 years of age have dense breast. Compared to conventional mammography, three-dimensional Tomosynthesis minimizes the numbers of errors that require additional screening or “callback” from imaging to ensure that there are no abnormalities. This additional screening includes diagnosis with mammographic or ultrasound imaging. It represents that 95% of call back areas are healthy and without overlapping tissue or adverse changes like the occurrence of cysts. All mammograms use x-ray technology, and thick tissues absorb more radiation than fatty ones. Some suspicious breast tumor areas are concealed or hidden by overlapping breast tissue, and a hidden cancer on a 2-dimensional mammography can appear in 3D mammography. Compared to 2D (standard type) mammography, 3D Tomosynthesis shows 50% more cancers present in a woman’s breast and greatly reduces false positives as well. 3D Tomosynthesis is a “gold standard” in breast screening mammography. Always ask your imaging facility if they use 3-D Tomosynthesis. What to Expect from a 3D Tomosynthesis Exam A tomosynthesis exam might be utilized as a screening tool in conjunction with conventional 2D digital mammography. As with a digital mammogram, your radiologist will take images from various angles. During the 3D tomosynthesis part of the exam, the X-ray arm of the mammography machine makes a fast arc over the breast. It will take a set of breast images at several angles. The entire process will take at least the same amount of time as that of a conventional digital mammogram, and the patient experience is very much the same.

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