The clinical usefulness of radiologic report monitoring system of CT and MRI in emergency department: analysis of missed and incidental findings

¹Department of Emergency Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
²Department of Emergency Medicine, Mediplex Sejong Hospital, Incheon, Korea

Correspondence

Jun Seok Seo ,Tel: 031-961-7777, Fax: 031-961-7529, Email: drsjs75@dongguk.edu,

Received: September 18, 2019; Revised: November 13, 2019 Accepted: November 13, 2019. Published online: August 31, 2020.

ABSTRACT

Objective:
This study was undertaken to establish a radiologic report monitoring system (RRMS) for missed and incidental findings (MIFs) in computed tomography (CT) and magnetic resonance imaging (MRI) reports, to help determine the clinical significance of MIFs in the emergency department (ED).
Method:
Patients presenting to our ED in 2017 were subjected to RRMS. Preliminary reports and final reports were subsequently compared based on the clinical significance of the MIFs. If required, the patient was contacted and instructed to revisit the ED.
Results:
Totally, 12,132 CT and MRI exams were performed during the study period, and 321 cases (2.6%) encompassed MIFs. We attempted to contact 228 cases (1.9%) who had clinically significant MIF findings; 9 patients were instructed to return to the ED, whereas 105 cases were instructed to report to the outpatient department. Hospitalization was required for 12 patients: 2 cases required surgical intervention, 2 cases had an additional procedure, and 8 cases required medical hospitalization.
Conclusion:
This study applied RRMS for a timely assessment of MIFs, determine rearrangements required, and present an active response to the MIFs determined in the ED. To improve patient care and safety, we hereby propose monitoring MIFs using the RRMS or similar methods.

Key words: Emergency departments; Incidental findings; Reports; Radiology information systems