Oncologic neurorads giving second-opinion reads hit 100 percent correct rate

Second-opinion interpretations of neuroimaging studies by subspecialized oncologic neuroradiologists can significantly cut error rates and, in the process, improve cancer care, according to the authors of a study published in the Sept. 1 issue of the biweekly journal Cancer.

Vaios Hatzoglou, MD, of Memorial Sloan Kettering Cancer Center and colleagues arrived at this conclusion after retrospectively analyzing initial outside and second-opinion radiology reports from close to 300 CT and MRI studies at their institution in New York.

The team first identified cases with discrepancies between the two reports, then had each pair of discrepant reports reviewed by an adult neuro-oncologist, a pediatric neuro-oncologist, and a head and neck surgeon.

The researchers assigned reviewers to the radiology reports based on the age of the patient, the type of study performed and the reviewer’s area of expertise.

The clinicians were blinded to the origin of each report.

Hatzoglou and colleagues recorded whether the differences in the reports would have led to a change in patient management and/or disease staging.

They established which of the two reports was correct based on histopathologic analysis, clinical assessment and/or minimum three-month imaging follow-up.

Among the 283 cases that met the study criteria, 55 neuroimaging studies (19 percent) had disagreements 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 percent) based on report differences as determined by the two neuro-oncologists and the surgeon participating in the study, Hatzoglou et al. report.  

Sufficient follow-up was available in 35 of 42 cases (83 percent)—and the second-opinion interpretation was correct 100 percent of the time (35 of 35).

“Second-opinion interpretations of neuroimaging studies by subspecialized oncologic neuroradiologists provide added value,” the authors write, “by reducing error and optimizing the care of cancer patients.”