Body MRI Subspecialty Reinterpretations at a Tertiary Care Center: Discrepancy Rates and Error Types

Kostrubiak, Danielle E.; DeHay, Price W; Ali, Naiim; D'Agostino, Robert; Keating, David P.; Tam, Judy K.; Akselrod, Dmitriy

doi:10.2214/ajr.20.22797

Cited by 10 publications

(6 citation statements)

References 17 publications

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“…[48][49][50] There are also protocol differences according to institution and discrepancies between radiologists. Kostrubiak et al 17 M1 disease, defined as positive peritoneal cytology or metastasis to sites other than regional LNs, is a pivotal point in staging gastric cancer. Distant metastases are identified in 16%-59% of patients at the time of diagnosis of gastric cancer 51,52 and are most frequently identified in the peritoneum (61%-80%) followed by distant LN (44%-50%) and the liver (26%-38%).…”

Section: Measurements Of Apparent Diffusion Coefficient (Adc) Values Asmentioning

confidence: 99%

“…There are also protocol differences according to institution and discrepancies between radiologists. Kostrubiak et al 17 showed that 68.9% of MRIs reviewed at a tertiary care center by fellowship‐trained radiologists had a discrepancy from the outside review. These were most commonly a misidentification of an abnormality or missing further abnormalities once one was found.…”

Section: N‐stagingmentioning

confidence: 99%

“…This suggests that the accuracy of MRI reading is related to experience. Traveling to a tertiary care center for scans can be a barrier to care for patients, particularly in rural and underserved areas 17 …”

Section: N‐stagingmentioning

confidence: 99%

“…MRI offers superb soft‐tissue contrast resolution and the ability to accurately differentiate soft tissue layers of the gastric wall. However, MRI is often less accessible, has longer acquisition times, is prone to image degradation from respiratory and peristaltic motion artifacts, requires experienced radiologists, and is more expensive than CT 10,16,17 …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Current and future imaging modalities in gastric cancer

Tham

Sestito

Markovich

et al. 2022

Journal of Surgical Oncology

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Gastric adenocarcinoma treatment can include endoscopic mucosal resection, surgery, chemotherapy, radiation, and palliative measures depending on staging. Both invasive and noninvasive staging techniques have been used to dictate the best treatment pathway. Here, we review the current imaging modalities used in gastric cancer as well as novel techniques to accurately stage and screen these patients.

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Section: Measurements Of Apparent Diffusion Coefficient (Adc) Values Asmentioning

confidence: 99%

Section: N‐stagingmentioning

confidence: 99%

Section: N‐stagingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Current and future imaging modalities in gastric cancer

Tham

Sestito

Markovich

et al. 2022

Journal of Surgical Oncology

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show abstract

“…To successfully decentralize imaging services at a larger scale, however, it is important to define value not just from the perspective of the healthcare system, but also from the perspective of the patient. Despite widespread encouragement to incorporate the patient voice in healthcare, developments such as RRCs are usually done without meaningful input from patients 7 . In the push for patient-centeredness, CMS recommends hospital departments incorporate patient insight into their service quality measures 8 .…”

Section: Introductionmentioning

confidence: 99%

Patient Preferences for Diagnostic Imaging Services: Decentralize or not?

van den Broek-Altenburg,

Benson,

Atherly

et al. 2024

Preprint

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The objective of this study was to identify patient preferences for outpatient diagnostic imaging services and analyze how patients make trade-offs between attributes of these services using a discrete choice experiment (DCE). We used a DCE with 14 choice questions asking which imaging locations patients would prefer. We used latent class analysis to analyze preference heterogeneity between different patient groups and to estimate the relative value they assign to different attributes of imaging services. Our analysis showed that the “Experienced Patients” subgroup generally value diagnostic imaging services in both acute and chronic situations and had a strong preference for hospital outpatient radiology departments (HORD) that would provide services at lower costs, where their images would be interpreted by a specialty radiologist, the clinic would be recommended by their PCP, online scheduling would be available, service rating were higher, and travel and wait times would be shorter. New Patients significantly valued the service rating of the hospital outpatient radiology departments (HORD) and online scheduling. HORDs can be more competitive by providing services that live up to expectations better than available retail radiology clinics (RRCs). Most RRCs do not currently offer online scheduling so ease of use may also steer patients towards HORDs. HORDs have the advantage of being linked to the main medical center which has the reputation of having clinical expertise and more sophisticated technology. We conclude that there is room for medical centers to build HORDs that provide an appealing and competitive alternative to current RRC.

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CT Imaging as a Single Modality for Clinical Staging of Gastric Cancer in Limited Resource Centers: A Retrospective Pilot Study

Klingbeil,

Eng,

Dube

et al. 2024

Journal of Surgical Oncology

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BackgroundGastric cancer disproportionately impacts populations in resource‐limited settings. Within a safety‐net network, we assessed the utility of computed tomography (CT) as a single staging modality.MethodsWe utilized a clinical database of gastric cancer patients treated within the Los Angeles County safety‐net hospital system from 2016 to 2023 in conjunction with retrospective imaging review by certified radiologists. We assessed agreement between clinical and pathological staging for patients who underwent curative gastrectomy using the Kappa coefficient.ResultsOf 107 patients with available CT imaging, 43.9% (n = 47) were staged with CT as a single modality. Most tumors displayed infiltrating (75%) or diffuse (28%) morphology, 41% displayed adequate gastric distention and regional lymphadenopathy was common (68%). Twenty‐nine patients underwent curative gastrectomy. Overall agreement was minimal (κ = 0.29, 95% CI [0.071−0.51], p = 0.022), weak for T3/T4 tumors (κ = 0.50, 95% CI [0.17−0.82], p < 0.01), and weak for Hispanic/Latino patients (κ = 0.47, 95% CI [0.19−0.76], p < 0.01).ConclusionsThere was minimal agreement between clinical and pathologic staging when assessing clinical stage by CT imaging alone, suggesting that CT is not adequate as a single modality staging tool. While every effort should be made to obtain multimodal staging, larger studies are warranted to improve CT imaging protocols for staging in resource‐limited settings.

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Body MRI Subspecialty Reinterpretations at a Tertiary Care Center: Discrepancy Rates and Error Types

Cited by 10 publications

References 17 publications

Current and future imaging modalities in gastric cancer

Current and future imaging modalities in gastric cancer

Patient Preferences for Diagnostic Imaging Services: Decentralize or not?

CT Imaging as a Single Modality for Clinical Staging of Gastric Cancer in Limited Resource Centers: A Retrospective Pilot Study

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