October 15, 2008

The Scan That Didn't Scan - An Article from Today's NY Times

Full article can be read at the New York Times
Picture above is from the New York Times
A very interesting article in one of the most read newspapers in the USA described an experience of the author (and a friend) having MRI scans at some New York hospitals. The author injured the foot and received the first MRI scan at a 'local' radiology center. They found nothing wrong and she was treated with medication without limiting activity. However, she hurt so much and got a second opinion at the Hospital for Special Surgery in New York. The second scan showed a stress fracture. The first scan quality was probably not good enough to detect the lesion (it missed the lesion), or the qualification of the first radiologist (general radiologist) is not enough.

The article also included several opinions from prominent radiologists including Dr Forman from Yale, Drs. Gazelle and Thrall from MGH.

I think the article is very important and any radiologists should read it because:

  • Being optimistic, the story brought radiologists to the light, criticized by lay people. It emphasizes how important radiologists are in the practice of medicine.
  • It teaches us that quality of the images produced, and experience of radiologists are very important for interpretation and subsequent patient care. Good quality images = good quality interpretation. Good training of radiologists, technologists and good-quality scanners are crucial.
  • It raises an issue of the training and qualification of radiologists. One day, patients may ask "Who read my scans? Is he or she qualified for this interpretation?" Strangely, this article coincides with a few articles in the current issue of JACR (Journal of the American College of Radiology) talking about sub-specialization in Radiology.
  • It also tells us to 'treat the patient, not the images'. Lesson learned for the clinicians. Like Dr. Thrall said in this article, "scans, as good as they are, are not perfect."
Listen to an accompanied Podcast HERE (in Thai language)

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