Is there an association between radiologist turnaround time of emergency department abdominal CT studies and radiologic report quality?

The aim of this study was to assess for an association between radiologists' turnaround time (TAT) and report quality for emergency department (ED) abdominopelvic CT examinations. Reports of 60 consecutive ED abdominopelvic CT studies from five abdominal radiologists (300 total reports) were included. An ED radiologist, abdominal radiologist, and ED physician independently evaluated satisfaction with report content (1-10 scale), satisfaction with report clarity (1-10 scale), and extent to which the report advanced the patient on a previously published clinical spectrum scale (1-5 scale). TAT (time between completion of imaging and completion of the final report) and report quality were compared between radiologists using unpaired t tests; associations between TAT and report quality scores for individual radiologists were assessed using Pearson's correlation coefficients. The five radiologists' mean TAT varied from 35 to 53 min. There were significant differences in report content in half of comparisons between radiologists by observer 1 (p ≤ 0.032) and in a minority of comparisons by observer 2 (p ≤ 0.047), in report clarity in majority of comparisons by observer 1 (p ≤ 0.031) and in a minority of comparisons by observer 2 (p ≤ 0.010), and in impact on patient care in a minority of comparisons for all observers (p ≤ 0.047). There were weak positive correlations between TAT and report content and clarity for three radiologists for observer 1 (r = 0.270-0.362) and no correlation between TAT and any report quality measure for remaining combinations of the five radiologists and three observers (r = -0.197 to +0.181). While both TAT and report quality vary between radiologists, these two factors were not associated for individual radiologists.

Pattern recognition of benign nodules at ultrasound of the thyroid: which nodules can be left alone?

OBJECTIVE: The purpose of this study was to evaluate morphologic features predictive of benign thyroid nodules. MATERIALS AND METHODS: From a registry of the records of 1,232 fine-needle aspiration biopsies performed jointly by the cytology and radiology departments at a single institution between 2005 and 2007, the cases of 650 patients were identified for whom both a pathology report and ultrasound images were available. From the alphabetized list generated, the first 500 nodules were reviewed. We analyzed the accuracy of individual sonographic features and of 10 discrete recognizable morphologic patterns in the prediction of benign histologic findings. RESULTS: We found that grouping of thyroid nodules into reproducible patterns of morphology, or pattern recognition, rather than analysis of individual sonographic features, was extremely accurate in the identification of benign nodules. Four specific patterns were identified: spongiform configuration, cyst with colloid clot, giraffe pattern, and diffuse hyperechogenicity, which had a 100% specificity for benignity. In our series, identification of nodules with one of these four patterns could have obviated more than 60% of thyroid biopsies. CONCLUSION: Recognition of specific morphologic patterns is an accurate method of identifying benign thyroid nodules that do not require cytologic evaluation. Use of this approach may substantially decrease the number of unnecessary biopsy procedures.