Radiologists Can Decrease Unnecessary Scans after Pelvic Ultrasounds

Reducing unnecessary imaging reduces patient anxiety, additional medical interventions and costs say findings of a study published in the Journal of the American College of Radiology.

Researchers from Seattle, Wash. undertook a study of pelvic ultrasounds to determine if the quality of pelvic ultrasound reports could be improved, and the number of physiologic and benign adnexal lesions that were unnecessarily referred for follow-up could be reduced. Adnexal cysts are commonly detected in pelvic ultrasounds. Most of incidentally detected adnexal cysts are benign and among premenopausal women, most cysts are physiologic.

The ultrasounds that indicated adnexal cysts were separated into two interventions. Intervention 1 involved educational efforts for the ultrasound radiologists and the sonographers. Intervention 2 involved the previous educations program, supplemented with the Society of Radiologists in Ultrasound (SRU) Consensus Statement (2010) white paper outlining the management of these cysts.

There were three data collection points: January 2006 (baseline), January 2008 and January 2011.

The researchers identified 252 pelvic ultrasounds performed in January 2006. Fifty-eight (23 percent) reported an adnexal lesion and 31 (12 percent) recommended follow-up. Upon retrospective review, the researchers found that 17 of the 31 lesions (55 percent) that were referred for follow-up were physiologic or benign.

After Intervention 1, retrospective review of the ultrasounds from January 2008 found that 17 of 31 (55 percent) reported adnexal lesions with 18 (8 percent) recommending follow-up. After intervention 2, 62 of 296 (22 percent) pelvic ultrasounds from January 2011 reported an adnexal lesion, with 16 (5 percent) recommending follow-up. The researchers found that recommendations for follow-up decreased 58 percent.

“We have demonstrated that elimination of some unnecessary imaging is under the control of the radiologist in the reporting of radiologic findings and the making of recommendations,” the authors wrote. This allowed a reduction of unnecessary images.