Understanding Radiology Discrepancies: A Case Cross-Sectional CT Study in a Tertiary Care Setting

Introduction: In modern healthcare, computed tomography (CT) is essential for diagnosing a wide range of medical conditions, particularly in emergency settings where timely evaluation of critical areas such as the brain, thorax, abdomen, and pelvis is crucial. However, the increasing reliance on provisional reports generated by postgraduates during on-call hours introduces challenges, as discrepancies often arise between these initial reports and final assessments by senior radiologists. These discrepancies can affect patient outcomes, particularly in complex cases, underscoring the need for studies that evaluate the patterns and clinical relevance of discrepancies across multiple CT modalities.

Aims and objective: This study aims to evaluate the discrepancy rates between provisional and final radiology reports of cross-sectional CT imaging, focusing on their clinical significance in a tertiary care setting.

Methods: A retrospective analysis was conducted on 1250 CT scans performed during on-call hours at a tertiary care hospital in Pondicherry, India. The study was carried out over one year, from July 2023 to June 2024. It included thoracic, abdominal, pelvic, and brain cross-sectional CT studies. Discrepancies between provisional reports provided by postgraduates and final consultant reports were identified and categorized as major or minor, based on their clinical significance. The American College of Radiology (ACR) RADPEER scoring system was utilized for classification, and statistical analysis was performed to evaluate trends based on postgraduate experience and scan type.

Results: Of the 1250 cases reviewed, 14% exhibited discrepancies between the provisional and final reports, with 6% classified as clinically significant. Abdominal and brain CT scans showed the highest discrepancy rates. A decreasing trend in the rate of discrepancies was observed as postgraduate seniority increased. None of the discrepancies led to adverse clinical outcomes.

Conclusion: The study demonstrates that while provisional reporting by postgraduates is generally accurate, discrepancies, particularly in abdominal and brain imaging, remain a concern. Strengthening training and supervision may help reduce clinically significant discrepancies, thereby enhancing patient safety and care.