Skip to main content
Top
Published in: Pediatric Radiology 8/2021

Open Access 01-07-2021 | Magnetic Resonance Imaging | Original Article

Performance of overnight on-call radiology residents in interpreting unenhanced abdominopelvic magnetic resonance imaging studies performed for pediatric right lower quadrant abdominal pain

Authors: David M. Sawyer, Raza Mushtaq, Srinivasan Vedantham, Faryal Shareef, Sara M. Desoky, Hina Arif-Tiwari, Dorothy L. Gilbertson-Dahdal, Unni K. Udayasankar

Published in: Pediatric Radiology | Issue 8/2021

Login to get access

Abstract

Background

Abdominopelvic magnetic resonance imaging (MRI) is increasingly being used to evaluate children with abdominal pain suspected of having acute appendicitis. At our institution, these examinations are preliminarily interpreted by radiology residents, especially when performed after hours.

Objective

To determine the accuracy of preliminary reports rendered by radiology residents in this setting.

Materials and methods

Three hundred seventy-seven pediatric abdominopelvic MRI examinations were included. The preliminary (resident) and final (attending) radiology reports were coded as diagnosing acute appendicitis or no acute appendicitis. The concordance between resident and attending radiologist interpretations was calculated. Additionally, both resident and attending reports were compared to available surgical pathology or clinical follow-up data.

Results

Overall concordance rate for the diagnosis of acute appendicitis was 97.1%. Concordance for verified cases of acute appendicitis was 93.4%. Concordance rates did not differ by residents’ postgraduate year levels. When compared against surgical pathology or clinical follow-up data, residents demonstrated 91.2% sensitivity and 97.6% specificity. There was no statistically significant difference in the sensitivity or specificity of resident or attending radiologist interpretations.

Conclusion

Radiology residents demonstrate high concordance with attending pediatric radiologists in their interpretations of pediatric abdominopelvic MRI for acute appendicitis. The diagnostic performances of residents and attendings were comparable.
Literature
1.
go back to reference Tseng Y-C, Lee M-S, Chang Y-J, Wu H-P (2008) Acute abdomen in pediatric patients admitted to the pediatric emergency department. Pediatr Neonatol 49:126–134CrossRef Tseng Y-C, Lee M-S, Chang Y-J, Wu H-P (2008) Acute abdomen in pediatric patients admitted to the pediatric emergency department. Pediatr Neonatol 49:126–134CrossRef
2.
go back to reference Bachur RG, Hennelly K, Callahan MJ et al (2012) Diagnostic imaging and negative appendectomy rates in children: effects of age and gender. Pediatrics 129:877–884CrossRef Bachur RG, Hennelly K, Callahan MJ et al (2012) Diagnostic imaging and negative appendectomy rates in children: effects of age and gender. Pediatrics 129:877–884CrossRef
3.
go back to reference Expert Panel on Pediatric Imaging, Koberlein GC, Trout AT et al (2019) ACR Appropriateness Criteria suspected appendicitis–child. J Am Coll Radiol 16:S252–S263 Expert Panel on Pediatric Imaging, Koberlein GC, Trout AT et al (2019) ACR Appropriateness Criteria suspected appendicitis–child. J Am Coll Radiol 16:S252–S263
4.
go back to reference Cundy TP, Gent R, Frauenfelder C et al (2016) Benchmarking the value of ultrasound for acute appendicitis in children. J Pediatr Surg 51:1939–1943CrossRef Cundy TP, Gent R, Frauenfelder C et al (2016) Benchmarking the value of ultrasound for acute appendicitis in children. J Pediatr Surg 51:1939–1943CrossRef
5.
go back to reference Saito JM, Yan Y, Evashwick TW et al (2013) Use and accuracy of diagnostic imaging by hospital type in pediatric appendicitis. Pediatrics 131:e37–e44CrossRef Saito JM, Yan Y, Evashwick TW et al (2013) Use and accuracy of diagnostic imaging by hospital type in pediatric appendicitis. Pediatrics 131:e37–e44CrossRef
6.
go back to reference van Randen A, Bipat S, Zwinderman AH et al (2008) Acute appendicitis: meta-analysis of diagnostic performance of CT and graded compression US related to prevalence of disease. Radiology 249:97–106CrossRef van Randen A, Bipat S, Zwinderman AH et al (2008) Acute appendicitis: meta-analysis of diagnostic performance of CT and graded compression US related to prevalence of disease. Radiology 249:97–106CrossRef
7.
go back to reference Doria AS, Moineddin R, Kellenberger CJ et al (2006) US or CT for diagnosis of appendicitis in children and adults? A meta-analysis. Radiology 241:83–94CrossRef Doria AS, Moineddin R, Kellenberger CJ et al (2006) US or CT for diagnosis of appendicitis in children and adults? A meta-analysis. Radiology 241:83–94CrossRef
8.
go back to reference Duke E, Kalb B, Arif-Tiwari H et al (2016) A systematic review and meta-analysis of diagnostic performance of MRI for evaluation of acute appendicitis. AJR Am J Roentgenol 206:508–517CrossRef Duke E, Kalb B, Arif-Tiwari H et al (2016) A systematic review and meta-analysis of diagnostic performance of MRI for evaluation of acute appendicitis. AJR Am J Roentgenol 206:508–517CrossRef
9.
go back to reference Johnson AK, Filippi CG, Andrews T et al (2012) Ultrafast 3-T MRI in the evaluation of children with acute lower abdominal pain for the detection of appendicitis. AJR Am J Roentgenol 198:1424–1430CrossRef Johnson AK, Filippi CG, Andrews T et al (2012) Ultrafast 3-T MRI in the evaluation of children with acute lower abdominal pain for the detection of appendicitis. AJR Am J Roentgenol 198:1424–1430CrossRef
10.
go back to reference Petkovska I, Martin DR, Covington MF et al (2016) Accuracy of unenhanced MR imaging in the detection of acute appendicitis: single-institution clinical performance review. Radiology 279:451–460CrossRef Petkovska I, Martin DR, Covington MF et al (2016) Accuracy of unenhanced MR imaging in the detection of acute appendicitis: single-institution clinical performance review. Radiology 279:451–460CrossRef
11.
go back to reference Mushtaq R, Desoky SM, Morello F et al (2019) First-line diagnostic evaluation with MRI of children suspected of having acute appendicitis. Radiology 291:170–177CrossRef Mushtaq R, Desoky SM, Morello F et al (2019) First-line diagnostic evaluation with MRI of children suspected of having acute appendicitis. Radiology 291:170–177CrossRef
12.
go back to reference Mellnick V, Raptis C, McWilliams S et al (2016) On-call radiology resident discrepancies: categorization by patient location and severity. J Am Coll Radiol 13:1233–1238CrossRef Mellnick V, Raptis C, McWilliams S et al (2016) On-call radiology resident discrepancies: categorization by patient location and severity. J Am Coll Radiol 13:1233–1238CrossRef
13.
go back to reference Cooper VF, Goodhartz LA, Nemcek AA, Ryu RK (2008) Radiology resident interpretations of on-call imaging studies: the incidence of major discrepancies. Acad Radiol 15:1198–1204CrossRef Cooper VF, Goodhartz LA, Nemcek AA, Ryu RK (2008) Radiology resident interpretations of on-call imaging studies: the incidence of major discrepancies. Acad Radiol 15:1198–1204CrossRef
14.
go back to reference Filippi CG, Schneider B, Burbank HN et al (2008) Discrepancy rates of radiology resident interpretations of on-call neuroradiology MR imaging studies. Radiology 249:972–979CrossRef Filippi CG, Schneider B, Burbank HN et al (2008) Discrepancy rates of radiology resident interpretations of on-call neuroradiology MR imaging studies. Radiology 249:972–979CrossRef
15.
go back to reference Walls J, Hunter N, Brasher PMA, Ho SGF (2009) The DePICTORS study: discrepancies in preliminary interpretation of CT scans between on-call residents and staff. Emerg Radiol 16:303–308CrossRef Walls J, Hunter N, Brasher PMA, Ho SGF (2009) The DePICTORS study: discrepancies in preliminary interpretation of CT scans between on-call residents and staff. Emerg Radiol 16:303–308CrossRef
16.
go back to reference Meyer RE, Nickerson JP, Burbank HN et al (2009) Discrepancy rates of on-call radiology residents' interpretations of CT angiography studies of the neck and circle of Willis. AJR Am J Roentgenol 193:527–532CrossRef Meyer RE, Nickerson JP, Burbank HN et al (2009) Discrepancy rates of on-call radiology residents' interpretations of CT angiography studies of the neck and circle of Willis. AJR Am J Roentgenol 193:527–532CrossRef
17.
go back to reference Issa G, Taslakian B, Itani M et al (2015) The discrepancy rate between preliminary and official reports of emergency radiology studies: a performance indicator and quality improvement method. Acta Radiol 56:598–604CrossRef Issa G, Taslakian B, Itani M et al (2015) The discrepancy rate between preliminary and official reports of emergency radiology studies: a performance indicator and quality improvement method. Acta Radiol 56:598–604CrossRef
18.
go back to reference Huang CWC, Ali A, Chang YM et al (2019) Performance of on-call radiology residents in interpreting total spine MRI studies for the detection of spinal cord compression or cauda equina compression. AJR Am J Roentgenol 213:1341–1347CrossRef Huang CWC, Ali A, Chang YM et al (2019) Performance of on-call radiology residents in interpreting total spine MRI studies for the detection of spinal cord compression or cauda equina compression. AJR Am J Roentgenol 213:1341–1347CrossRef
19.
go back to reference Leeuwenburgh MMN, Wiarda BM, Bipat S et al (2012) Acute appendicitis on abdominal MR images: training readers to improve diagnostic accuracy. Radiology 264:455–463CrossRef Leeuwenburgh MMN, Wiarda BM, Bipat S et al (2012) Acute appendicitis on abdominal MR images: training readers to improve diagnostic accuracy. Radiology 264:455–463CrossRef
20.
go back to reference Moore MM, Brian JM, Methratta ST et al (2014) MRI for clinically suspected pediatric appendicitis: case interpretation. Pediatr Radiol 44:605–612CrossRef Moore MM, Brian JM, Methratta ST et al (2014) MRI for clinically suspected pediatric appendicitis: case interpretation. Pediatr Radiol 44:605–612CrossRef
21.
go back to reference Otero HJ, Smitthimedhin A, Wang CC, Heitzmann MD (2018) Case based simulation in MRI for suspected appendicitis in children. Clin Imaging 48:12–16CrossRef Otero HJ, Smitthimedhin A, Wang CC, Heitzmann MD (2018) Case based simulation in MRI for suspected appendicitis in children. Clin Imaging 48:12–16CrossRef
22.
go back to reference Shah NA, Hoch M, Willis A et al (2010) Correlation among on-call resident study volume, discrepancy rate, and turnaround time. Acad Radiol 17:1190–1194CrossRef Shah NA, Hoch M, Willis A et al (2010) Correlation among on-call resident study volume, discrepancy rate, and turnaround time. Acad Radiol 17:1190–1194CrossRef
23.
go back to reference Stevens KJ, Griffiths KL, Rosenberg J et al (2008) Discordance rates between preliminary and final radiology reports on cross-sectional imaging studies at a level 1 trauma center. Acad Radiol 15:1217–1226CrossRef Stevens KJ, Griffiths KL, Rosenberg J et al (2008) Discordance rates between preliminary and final radiology reports on cross-sectional imaging studies at a level 1 trauma center. Acad Radiol 15:1217–1226CrossRef
24.
go back to reference Ruchman RB, Jaeger J, Wiggins EF et al (2007) Preliminary radiology resident interpretations versus final attending radiologist interpretations and the impact on patient care in a community hospital. AJR Am J Roentgenol 189:523–526CrossRef Ruchman RB, Jaeger J, Wiggins EF et al (2007) Preliminary radiology resident interpretations versus final attending radiologist interpretations and the impact on patient care in a community hospital. AJR Am J Roentgenol 189:523–526CrossRef
Metadata
Title
Performance of overnight on-call radiology residents in interpreting unenhanced abdominopelvic magnetic resonance imaging studies performed for pediatric right lower quadrant abdominal pain
Authors
David M. Sawyer
Raza Mushtaq
Srinivasan Vedantham
Faryal Shareef
Sara M. Desoky
Hina Arif-Tiwari
Dorothy L. Gilbertson-Dahdal
Unni K. Udayasankar
Publication date
01-07-2021
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 8/2021
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-021-05009-8

Other articles of this Issue 8/2021

Pediatric Radiology 8/2021 Go to the issue