Diagnostic accuracy with US: Remote radiologists' versus on-site radiologists' interpretations

PURPOSE: To compare the diagnostic accuracy of radiologists interpreting st atic ultrasonographic (US) images electronically transmitted to an academic medical center (remote radiologists) with that of radiologists performing "hands-on" US at a community-based outpatient site (on-site radiologists). MATERIALS AND METHODS: During 8 months, 80 patients underwent pelvic US at a community-based outpatient site. Images were electronically transmitted t o a remote medical center as they were acquired at the community site and w ere printed on a laser printer identical to the one used at the outpatient site. The reference Standard for correct diagnosis was based on histopathol ogic findings (n = 13), additional imaging results (n = 34), or review by a second independent observer (n = 33). Both an on-site and a remote radiolo gist interpreted the images, and their interpretations were rated as agree, both correct; agree, both incorrect; or disagree. Cases of disagreement we re rated as major or minor. RESULTS: On-site and remote radiologists agreed in 69 of 80 patients (86%), and both radiologists were correct in all of these cases. There were 10 mi nor discrepancies and one major discrepancy. The diagnostic accuracies of t he on-site and remote radiologists were 92% and 94%, respectively. CONCLUSION: High levels of diagnostic accuracy can be achieved by radiologi sts interpreting static US images. Strict protocols acid excellent communic ation between the radiologist and sonographer are necessary to avoid diagno stic errors.