E1734. Second Opinion Interpretations by Sub-Specialty Trained Radiologists in Chest Imaging
  1. Zaid Haddadin; University of California - Los Angeles
  2. Cameron Hassani; University of California - Los Angeles
  3. Lila Pourzand; University of California - Los Angeles
  4. Mohammad Jalali; University of California - Los Angeles
  5. Fereidoun Abtin; University of California - Los Angeles
  6. Arash Bedayat; University of California - Los Angeles
The aim of this study is to assess the significance of subspecialty second-opinion consultations for CT examinations in cardiothoracic imaging.

Materials and Methods:
One hundred randomly selected CTs of the chest referred to a single academic institution for second-opinion consultation were reviewed by two radiologists in consensus. Outside and inside reports were compared using a previously published 5-point scale. Clinically important differences (categories 4 and 5) were defined as those likely to change patient management.

Of all second-opinion examinations, 69% (69/100) had an outside report available for comparison and inclusion in the study. There was no discrepancy in 70% of the included cases (48/69). In the remaining 30% (21/69), 6 cases (8%) had nonsignificant discrepancies (Type 2 or 3) and 15 cases (22%) had clinically significant discrepancies (Type 4 and 5).

The subspecialty second-opinion review by a thoracic fellowship trained radiologist was more meticulous than outside reports in 30% of studies. A moderate rate (30%) of discrepant interpretations was noted between outside and inside thoracic imaging examinations. The discrepancies were almost equal in interpreting vs detecting abnormalities (6 vs 7). The data suggest that there may be an added benefit of obtaining second opinion over-reads by subspecialty trained thoracic radiologists for CT examinations of the chest; potentially changing clinical management and improving patient care.