The edition · Radiology
One in seven patients given a follow-up imaging recommendation had a diagnostic error, mostly through delay; photon-counting CT rivals breast MRI for staging
A quality study of abdominal imaging finds most diagnostic errors happen after the report is signed, photon-counting CT matches MRI on breast lesion extent and beats it on nodes, deep learning finds cerebral microbleeds accurately in small studies, and six societies call for mandatory enhanced radiation protection in fluoroscopy labs.
The edition in brief
In a quality-improvement review of 185 adults whose abdominal imaging report recommended further imaging, 14.6% (95% CI 10.2% to 20.4%) had at least one diagnostic error, and the leading contributor was delay in performing the ordered test — a failure after the report, not in reading the image. In a prospective study of 126 women with BI-RADS 4C or higher breast lesions, contrast-enhanced photon-counting CT agreed with MRI on T category (kappa 0.86 to 0.88), was similar to MRI and 44% more sensitive than mammography for additional lesions, and was more sensitive than MRI for nodal metastases (difference 10%), but missed 44% of microcalcifications seen on mammography. A meta-analysis of deep learning for cerebral microbleeds found patient-level sensitivity 0.89 and specificity 0.86 from only five studies. A statement from six US societies including SCAI and SIR calls for mandatory adoption of enhanced radiation protection devices in fluoroscopy laboratories, citing cancer, cataract and orthopaedic harm to staff from lead aprons. The practical message: a follow-up recommendation needs a tracking system behind it, or it will often not happen in time.
Photon-counting CT matched breast MRI for local staging and beat it on nodes, but missed calcifications
Photon-counting CT staged breast cancer about as well as MRI and assessed nodes better, but missed many microcalcifications; it complements rather than replaces mammography.
Six societies call for mandatory enhanced radiation protection in fluoroscopy laboratories
Interventional and cardiac societies now say enhanced radiation protection should be mandatory in fluoroscopy suites; plan for it at the next equipment renewal.
Deep learning detected cerebral microbleeds accurately, but in only five patient-level studies
Deep-learning microbleed detection looks accurate but rests on few studies; use it only as an assistant after local validation.
Write a follow-up recommendation someone can act on
Every follow-up recommendation should give the modality, interval and reason in the impression, with a tracking flag.
One in seven patients with a recommended follow-up scan had a diagnostic error, mostly from delay
Build a closed-loop system for imaging follow-up recommendations; one in seven patients came to a diagnostic error, mostly because the test was delayed.
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