ARRS 2022 Abstracts

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E1244. Leveraging Peer Learning to Achieve Neuroradiology Practice and System Improvement
Authors
  1. Temilola Akinola; Lahey Hospital
  2. Mara Kunst; Lahey Hospital
  3. Jennifer Broder; Lahey Hospital
Background
In 2017, our department transitioned from scored peer review to peer learning. Over 4 years, recurrent case submissions have been identified in several categories, deemed to be “high-yield” for neuroradiology review on specific imaging exams. Sharing examples of these categories may inspire others beyond our department to pay close attention to these areas in their imaging review.

Educational Goals / Teaching Points
The goals of this exhibit are to identify and classify repeat neuroimaging peer learning case entries over a 4 year period; demonstrate learning opportunities through individual case examples; and educate and thereby reduce neuroradiology interpretive discrepancies beyond a single institution.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Cases submitted were confirmed as opportunities for individual and group learning in conference and formed the basis for broader, section-wide learning and improvement. It is important to note that these consisted of not only discrepancies/diagnostic errors but also good pick-ups. The identified categories for submitted cases were as follows. Relating to routine CT and MRI brain, these include vascular pathology (aneurysms, thrombosis, arteriovenous shunt), lesions in the extra axial spaces, pituitary, orbits, facial soft tissues/parotid, and scout/localizer imaging. Relating specifically to post-contrast MRI brain is cranial nerve pathology. Relating to CT cervical spine and CTA neck, repeat entries included pathology of the lung apices (nodules and pulmonary emboli). Relating to spine imaging, repeat entries included scout/localizer pathology, variation in spine counting, as well as lesions in the cord and adrenal glands. As a result of peer learning discussions, items were added to personal checklists and reports to reduce perceptive errors and to standardize reporting. Further discussion and literature review were undertaken to establish best practices for interpretation, reduce variations in interpretations among section members, and establish diagnostic standards/follow-up recommendations.

Conclusion
Beyond providing learning opportunities for individuals, peer learning cases can be used to achieve section-wide improvements and to establish standards of care.