Posted on Nov 30, 2020
Body MRI scans are used to help diagnose or monitor treatment for a variety of conditions within the chest, abdomen, and pelvis. But recent research found that nearly 70% of all body MRI interpretations have at least one discrepancy.
The study, performed by researchers at the University of Vermont and the University of Southern California Medical Center, identified the majority of errors to be of cognitive nature (misidentification of a finding). The results raise an important call for patients and referring providers to ensure body MRI studies are read by subspecialists.
We spoke with world-renowned abdominal and body imaging specialist, Dr. Richard Semelka, to learn how patients can avoid misdiagnoses and ensure accuracy with a body MRI subspecialty second opinion.
DocPanel is committed to making sure every patient receives excellent care. If you would like an expert second opinion on your medical imaging from Dr. Semelka or one of our other fellowship-trained subspecialty radiologists, you can learn more here.
“Body MRI scans are highly complex. Whether it's an abdominal MRI, pelvic MRI, chest MRI, or full body MRI - these types of scans require specific training and expertise to be read properly. In the field of radiology, this is called subspecialization. Ideally, every scan should be interpreted by the appropriate subspecialist - be that a breast imager, body imager, cardiac imager etc. But many imaging facilities and hospitals don't have a full team of subspecialists. In such cases, subspecilaity scans, like a body MRI, may end up getting read by a generalist - a radiologist without subspecialty training. This presents a high risk for cognitive error,” says Dr. Semelka.
“These mistakes frequently lead to delayed or incorrect treatment plans. Cancers can be missed, resulting in patient death within a few months. Benign lesions may be misdiagnosed as cancer, resulting in unnecessary extra tests and surgery - which contains the risk of complications, including death."
There are many nuances in a body MRI scan. Experience in identifying how different diseases can appear in imaging is crucial to an accurate interpretation. Quite literally, it can be a matter of life and death for a patient. Getting a second opinion empowers patients with an opportunity to make sure their scans are interpreted by a subspecialist.
With DocPanel, for example, you can either select the radiologist yourself - or you can opt to have the company's medical team select the best expert for you. Either way, there's complete transparency. And patients can rest assured that a subspecialist is reading thier scans. Now, you do have to be careful because not every second opinion service provider will have subspecialists. You need to do your research in making sure your scans are not sent to a generalist.”
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“Radiology practices often put pressure on radiologists to interpret a lot of scans in a short amount of time. This expectation for speed can lead to serious errors - even when a subspecialist is reading your scans. All it takes is one tiny area of a scan skimmed over too quickly and something can be missed.
When I provide second opinions for DocPanel patients, I know that I am taking my time, and providing a thorough review. This, combined with the expertise and familiarity that come with years of practice, allow me to catch things that were initially missed in the first interpretation.
“Another common error pertaining to thoroughness occurs because many body MRI scans are performed after an abnormality has already been identified on a previous imaging exam, such as an ultrasound of the liver or an abdominal CT scan. So when the radiologist reviews the body MRI, they are being asked to review a particular spot and to answer a specific question. What may happen in such cases, is that once the area in question is reviewed - the rest of the scan is not examined. If there are any other abnormalities present, they may be missed.”
“In addition to providing a second opinion on areas of concern, DocPanel radiologists will provide a complete interpretation of the entire scan.”
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“A body MRI is a tricky scan to perform. The technician must prioritize the patient’s comfort, as to minimize any body movements whatsoever. If the patient is not comfortable and moves during the scan, the movement can cause image artifact - any feature that appears on an image but is not present in reality. Image artifacts can also result from improper operation of the MRI machine. These false features can obscure the images produced during a body MRI, affecting the overall quality of the scan. If the quality is greatly compromised, it may make it difficult for the radiologist to provide an accurate interpretation.”
An experienced radiologist will have the expertise to determine image quality. If the radiologist does not have the proper experience, they may read the scan even when the images should be retaken.
"A perk of getting a subspecialty second opinion is that the radiologist can let you know if there are any quality issues and can recommend additional imaging if necessary. This can help prevent misdiagnoses.”
“The data captured in a body MRI scan is extremely valuable. MRI can capture more information than ultrasound and, depending on the medical issue, CT imaging. Getting a subspecialty second opinion can provide you with peace of mind that you and your doctors are getting the most out of the information provided by your body MRI scan. Even if your scans were initially read by a subspeciaist, a second set of eyes can help confirm a diagnosis before moving forward with a treatment plan.”