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E2196. Blind Spots in Pelvic Imaging
Authors
  1. Phoebe Ann; University of California, Los Angeles
  2. Iris Chen; University of California, Los Angeles
  3. Katrina Beckett; University of California, Los Angeles
  4. Simin Bahrami; University of California, Los Angeles
Background
As the volume of imaging rises and radiologists are expected to interpret studies at faster rates, it may be difficult to maintain the same degree of diagnostic accuracy. It is essential to recognize certain areas within the pelvis on routine pelvic imaging that radiologists may be more prone to making perceptual or cognitive errors.

Educational Goals / Teaching Points
The teaching points of this education exhibit include understanding the normal anatomy encountered on routine pelvic ultrasound, CT, and MR imaging. The exhibit will discuss the various “blind spots,” or the anatomic regions prone to misinterpreted findings, in pelvic imaging. The exhibit will also cover the diagnostic limitations and potential pitfalls in the interpretation of findings in these blind spots. The understanding of these concepts will then be reinforced through illustrative cases and interactive quiz questions.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This presentation will include a multi-modality pictorial review of blind spots in normal pelvic anatomy that commonly predispose to diagnostic errors. The main cause of diagnostic errors in radiology include perceptual (failure to identify) and cognitive (failure to recognize significance) errors, and examples of each type of error will be demonstrated. The pelvic blind spots that may be prone to perceptual errors include the cervix and vagina, serosal surfaces, pelvic floor, abdominal wall, ureters, psoas muscles, and osseous structures. Following a standardized approach in interpreting pelvic imaging is crucial to ensuring comprehension evaluation, and we will include a sample checklist for evaluation of these blind spots in various imaging modalities. Strategies to improve interpretation include recognizing the various types of diagnostic errors, carefully evaluating blind spots on every study, comparing with prior imaging when possible, obtaining the patient’s clinical history, changing the window width and level, and utilizing multiplanar reconstructions.

Conclusion
Knowledge of the blind spots in multi-modal pelvic imaging is paramount in avoiding interpretation pitfalls and maintaining the diagnostic accuracy necessary for patient care.