Melvin D'Anastasi MD, Presenter: Nothing to Disclose

Yuliya Lakhman MD, Abstract Co-Author: Nothing to Disclose

Maura Micco MD, Abstract Co-Author: Nothing to Disclose

Chiara Scelzo MD, Abstract Co-Author: Nothing to Disclose

Dennis Chi MD, Abstract Co-Author: Nothing to Disclose

Nadeem Abu-Rustum, Abstract Co-Author: Nothing to Disclose

Hedvig Hricak MD, PhD, Abstract Co-Author: Nothing to Disclose

Evis Sala MD, PhD, Abstract Co-Author: Nothing to Disclose

To determine if second-opinion interpretations of outside gynecologic (GYN) magnetic resonance imaging (MRI) examinations by sub-specialty radiologists significantly impact patient care

The institutional review board approved the retrospective review of patient data for this HIPAA-compliant study, and waived the need for individual informed consent. Between January 2008 and July 2013, 469 second-opinion readings of outside GYN MRI studies were performed by one of four GYN-specialized radiologists. These interpretations were compared to the outside reports submitted with the images. All reports with any differences between the original and second-opinion interpretations were independently reviewed by two gynecologic oncology (GYN ONC) surgeons blinded to the origin of each report. Both surgeons recorded patient management based on each report and noted whether the differences between the reports were clinically significant, i.e. led to a change in patient management such as treatment approach, patient counseling, and/or patient referral.

Second-opinion interpretations of outside GYN MRIs by GYN-specialized radiologists changed patient management in 94/469 (20%) of patients for surgeon 1 (S1) and 101/469 (21.5%) of patients for surgeon 2 (S2). The treatment approach, patient counseling, and patient referral were altered based on second-opinion reports in 71/469 (15.1%), 92/469 (19.6%), and 50/469 (10.7%) of patients for S1 and 61/469 (13.0%), 101/469 (21.5%), 53/469 (11/3%) of patients for S2, respectively. Moreover, second-opinion reports resulted in a switch from surgical to nonsurgical management and surgical procedure change in 35/469 (7.5%) and 19/469 (4.1 %) of patients for S1 and 31/469 (6.6%) and 12/469 (2.5%) of patients for S2, respectively. MRI interpretations by GYN-specialized radiologists were accurate in 82.3% of cases with histopathologic specimens and imaging follow-up as reference standards.

Second-opinion interpretations of outside GYN MRI examinations by the radiologists who specialize in gynecologic imaging have a significant impact on patient care.

Second-opinion interpretations of outside GYN MRI studies by the experts in gynecologic imaging significantly change patient management.

D'Anastasi, M, Lakhman, Y, Micco, M, Scelzo, C, Chi, D, Abu-Rustum, N, Hricak, H, Sala, E, Second-opinion Interpretations of Gynecological MRI by Subspecialty Radiologists Benefit Patient Care.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014323.html