Variation in the quality of lumbar spine MR images in Washington State

PURPOSE: To investigate the variation in quality of lumbar spine magnetic r esonance (MR) images as a function of type of ownership of the imaging cent er, number of studies performed per month, specialty training of the image interpreter, and field strength of the MR unit. MATERIALS AND METHODS: Data were collected from all imaging facilities in w estern Washington state that received reimbursement from the Washington Sta te Health Care Authority. Three readers with expertise in spine imaging, wh o were blinded to center and patient identification information, rated the technical image quality-of each study. All MR images of the lumbar spine (m aximum of six) paid for by the health care authority were evaluated. If a c enter had performed more than six studies, then six were randomly selected for evaluation. RESULTS: Variation in quality scores among sites was significant (P = .001) . Field strength was the strongest predictor of better quality. Poorer qual ity was associated with for-profit ownership, a larger number of radiologis ts at the site reading MR images, and a larger percentage of studies checke d by a radiologist prior to the end of the examination. CONCLUSION: There was significant variation in the quality of MR images of the lumbar spine, and at least a portion of this Variation was attributable to characteristics of the imaging center.