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Quality Initiatives

Missed Lesions at Abdominal Oncologic CT: Lessons Learned from Quality Assurance¹

¹ From the Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215. Presented as an education exhibit at the 2003 RSNA Annual Meeting. Received September 12, 2007; revision requested December 19 and received February 5, 2008; accepted February 21. J.S. receives research support from Koninklijke Philips Electronics; V.R. receives research support from Toshiba and E-Z-Em; all other authors have no financial relationships to disclose. Address correspondence to B.S. (e-mail: bsiewert{at}bidmc.harvard.edu).

The evaluation of oncology patients represents a substantial volume of the workload in many radiology departments. Interpreting the results of oncologic examinations is often challenging and time-consuming because many abnormalities are identified in the same examination and must be compared with the findings in previous studies. However, errors in the interpretation of oncologic computed tomographic (CT) scans can have significant effects on patient care. These effects may range from withdrawal from a clinical trial or cessation of therapy to repeat CT examination because of a technically inadequate study, CT-guided biopsy of newly identified lesions, or initiation of therapy for previously unrecognized lesions. A root cause analysis of reported errors in the interpretation of abdominal and pelvic CT scans led to the identification of potential pitfalls that may be encountered when interpreting oncologic CT scans and factors that contribute to these errors. Awareness of the spectrum of factors that contribute to misinterpretation of CT scans in oncology patients may improve the performance of the individual radiologist and ultimately translate into improved patient care.

© RSNA, 2008