Radiology-pathology report pairing system works wonders for radiologists

Radiology-pathology report pairing can provide potential opportunities for learning and improved accuracy when matched by organ systems, according to a new article published in Academic Radiology.

“Radiology-pathology correlation is an essential component of learning radiology,” wrote lead author William Moore, MD, New York University Langone Medical Center, and colleagues. “Accurate and timely feedback, such as that provided by radiology-pathology correlation, is a crucial element in developing expertise and accuracy in diagnosis. However, aside from breast imaging, rigorous radiology-pathology correlation is haphazardly performed, with the majority of the correlation requiring the radiologist to actively seek pathologic results via the medical record or discussion with clinicians.”

To test the accuracy of radiology-pathology pairings, the researchers used an automated radiology-pathology module, which sent both reports to the interpreting radiologist. The module alerted reporting radiologists to matching pathologic pairings through a computerized module integrated with PACS and via a secured email. Pairings were scored as either correlative—pathology reports relating to the anatomy imaged in the specific study—or non-correlative.

Of the 9,000 pairings tested, there was an 88 percent correlation of radiology and pathology reports. A greater than 91 percent correlation was demonstrated by computed tomography (CT), abdomen/pelvis, CT head/neck/face, CT chest, musculoskeletal CT (excluding spine), mammography, magnetic resonance imaging (MRI) abdomen/pelvis, MRI brain, musculoskeletal MRI (excluding spine), breast MRI, positron emission tomography (PET), breast ultrasound and head/neck ultrasound.

By imaging modality, CT, MRI, mammography, and PET all had a correlation of greater than 96 percent. However, ultrasound and non-PET nuclear medicine studies had poorer correlation of only 80 percent.

“There is excellent correlation of radiology imaging reports and appropriate pathology reports when matched by organ system,” the authors wrote. “Rapid, appropriate radiology-pathology report pairings provide an excellent opportunity to close feedback loop to the interpreting radiologist.”

To better understand radiologists’ response to the module, the researchers sent a survey to radiologists and 18 responded. Approximately 89 percent of the physicians rated the module as “easy” or “very easy” to use. Approximately 78 percent were “satisfied” or “very satisfied” with how the imaging and clinical information is presented in the radiology-pathology email notifications. And approximately 67 percent of physicians believed improvement in imagining interpretation would be the largest benefit of the email notifications. Only 22 percent reported that departmental quality assurance or improvement was the largest benefit.

The authors also noted that utilizing a radiology-pathology email notifications system increased follow up of all cases.