Who’s Behind the Screen? Why Your Radiologist Matters

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All your scan images will be “read” on a computer screen by a doctor specializing in imaging, called a radiologist. So are all radiologists created equal, or could it make a difference to you who it is?
Who Is Reading Your Scan?

Have you ever wondered who the person in the dark room – the radiologist, reading through your on-screen CT or MRI scan images, writing that all important report – actually is? Just because you never meet them, or have no say in choosing who it is, does that mean it doesn’t matter?

You may not be surprised to find out it does matter. Published research shows that the level of training that the radiologist reading your scan has undergone, can make a difference in how easily they are able to pick up important abnormalities and interpret the meaning of a finding.

Researchers have compared how more specialized or more experienced radiologists – whether it be in breast scans, musculoskeletal images or gynecology scans – have been shown to be more effective at picking up the correct diagnosis 1-3.  In a study involving over a hundred and thirty CT and MRI scans of the head and neck, a specialized neuroradiologist found that he picked up new information in 40% of the scans his patients arrived with, and nearly all the new findings affected the treatment the patient received. In 6 patients he found a new cancer which had been missed. In 3 patients he found that they had been misdiagnosed as having cancer in the first place4.

A specialized radiologist’s greater expertise means the likelihood of finding where something is amiss is greater. The likelihood of misinterpreting a normal difference as something worrisome drops. This could save you unnecessary worry or further tests or get you heading for the right treatment earlier.

Radiologists Are Like Detectives

When you have a CT or MRI scan, the machine generates a number of black and white images that are similar to cross-sections taken through your body. To the average person, a CT or MRI scan looks like a piece of abstract grayscale modern art. To a trained radiologist, the scan will show detailed representations of parts of your body that are under investigation. The radiologist will look through your scan images to search out any abnormalities that might explain the symptoms you are having. Sometimes they have to interpret whether slight differences they see are of importance to your health; everybody’ body is unique in its own way both on the outside and the inside, and an internal difference may be as unimportant as an exterior one, like a birthmark. It may be an irregularity created by the scan machine, just like when you take a blurred photograph of someone moving. On the other hand, it may be the sign of something that shouldn’t be there. The radiologist has to weigh up the information given to them by your referring physician – things like where your pain is, how old you are, any other symptoms – and use the images and their knowledge of the machine’s technical functions to piece together the puzzle that will help lead to an explanation.

The process of “reading” a scan can be done by a referring physician, too. Often surgeons in a specific field, for example, have years of experience looking at the same type of scans. However, most physicians rely on the expertise of radiology doctors, who have been specifically trained to interpret scan images in much greater depth. So why does it matter which radiologist interprets your scan?

How Your Radiologist Became an Expert

To become fully trained, a radiologist has undergone:

– 4 years of college

– 4 years of medical school

– 4/5 years of internship and residency training in radiology

At this point they can go to work reading your scans. However, many radiologists choose to become “board-certified” with the American Board of Radiology by also taking on challenging further exams that require in-depth study.

After this, some choose to become “fellowship-trained” by taking on another few years of specialization in one particular branch of radiology. Fellowship-trained radiologists have chosen to undergo extensive extra training to become experts in a smaller field of radiology, such as neuroradiology or musculoskeletal radiology. They truly have become the experts in their sub-specialization. One research study showed that immediately after fellowship-training, subspecialized radiologists perform at an equivalent level to radiologists with many years of experience5.

So How Can I Ensure I Get the Most Experienced Radiologist?

Your referring doctor may have a strong preference of where you have your scan. Sometimes your scan needs very specialized imaging equipment, or special dyes, or you might need an anesthetic. However oftentimes doctors just need a quality scan, and they refer to their local hospital imaging departments simply because they are easiest to refer to, or because they have established contracts. However, you have the right to choose where to have your scans, and the right to choose for quality reports. 

At Tellica, all the radiologists reading your scans are fellowship-trained and board-certified. Furthermore, these are the same radiologists that read scans for the best Intermountain hospitals in Utah, the same radiologists that read scans for the specialist surgical, cancer and other teams day in and day out. Quality is of utmost importance to our team and will never be compromised for cost. By choosing to have your scan here at Tellica, you are ensuring your images are being seen by the most experienced medical detectives possible.

Ask your referring physician if they can refer you to Tellica for the scans you need.

  1. Sickles EA, Wolverton DE, Dee KE. “Performance parameters for screening and diagnostic mammography: specialist and general radiologists.” Radiology. 2002 Sep; 224(3):861-9.
  2. Chalian M, Del Grande F, Thakkar RS, Jalali SF, Chhabra A, Carrino JA. “Second-Opinion Subspecialty Consultations in Musculoskeletal Radiology.” AJR Am J Roentgenol. 2016 Jun;206(6):1217-21
  3. Lakhman Y, D’Anastasi M, Miccò M, et al. “Second-opinion interpretations of gynecologic oncologic MRI examinations by sub-specialized radiologists influence patient care.” Eur Radiol. 2016;26:2089–2098
  4. Loevner LA, Sonners AI, Schulman BJ, et al. Reinterpretation of cross-sectional images in patients with head and neck cancer in the setti ng of a multidisciplinary cancer center. AJNR Am J Neuroradiol. 2002;23:1622–1626
  5. Miglioretti DL, Gard CC, Carney PA, Onega TL, Buist DS, Sickles EA, Kerlikowske K, Rosenberg RD, Yankaskas BC, Geller BM, Elmore JG. “When radiologists perform best: the learning curve in screening mammogram interpretation.” Radiology 2009 Dec; 253(3):632-40.