Michael Tse-Yin Lu MD, Presenter: Nothing to Disclose

Wyatt Michael Tellis PhD, Abstract Co-Author: Officer, EyePACS LLC

David E. Avrin MD, PhD, Abstract Co-Author: Stockholder, Amirsys, Inc Consultant, Amirsys, Inc

Repeat imaging at the transfer of care between institutions is a potential source of overutilization. The purpose of this study was to assess whether importing outside imaging to PACS reduces repeat imaging, thus sparing patients unnecessary cost and radiation.

Informed consent was waived for this retrospective, HIPAA-compliant study. One-hundred and thirty-three patients who had a CT or MR of the abdomen at an outside institution in the 6 months prior to transarterial chemoembolization (TACE) at our institution were considered. The patients were divided into three groups based upon the availability of their outside imaging: a) outside imaging not available, b) outside imaging available on CD or film but not imported and c) outside imaging imported to PACS. The rate of repeat imaging was compared between the three groups. Repeat imaging was said to occur when a CT or MR of the abdomen performed at another institution was followed by the same study at our institution.  Imaging performed for an acute indication or because the prior imaging was technically inadequate was not considered repeat imaging.

Repeat imaging occurred in 75% (18/24) when outside imaging was not available, 56% (15/27) when outside imaging was available but not imported, and 12% (10/82) when outside imaging was imported to PACS. Patients whose outside imaging was imported were significantly less likely to have repeat imaging than both groups whose outside imaging was not imported (p < 0.001). The odds of repeat imaging was significantly lower for patients whose outside imaging was imported compared with those whose outside imaging was available on CD or film but not imported (odds ratio = 0.11, 95% CI: 0.041 – 0.30, p < 0.001).

Importing outside imaging to PACS reduces repeat imaging.

Institutions should consider importing outside imaging to PACS.  Vendors should adhere to DICOM and IHE standards to ensure that portable media is importable.

Lu, M, Tellis, W, Avrin, D, Impact of Importing Outside Imaging to PACS on Repeat Imaging.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11001151.html