What do radiologists look at?

[brockenspectre]

I have been having a debate with a couple of friends about what it is radiologists look at and I am hoping that someone here can clarify for me!

If you have your abdomen scanned because your doctor (of any specialty that manages the trunk) has requested it, does the radiologist only report on those issues they see pertaining to the target, or do they review everything that has been caught in the scan?

Both my friends say that the radiologist will only report on the matter they have been asked to investigate (ie, bowel, liver etc), whereas my view is that while the target area is the prime mover for the scan in question, a radiologist will review the slides/films and report on anything seen that isn't what it should be irrespective of where it is.

Can someone here tell me what is correct please? and does this vary depending on what country you are in?

Thanks in advance for any/all replies

[kwachon]

As a cancer survivor, I can assure you I have had my share of scans, x-rays etc. My cancer was found by a radiologist investigating a complaint nothing to do with the cancer tumor ( I was not aware I had one), in fact all he did was advise me that there was a small shadow on the very edge of my x-ray and that I should talk to my doc about getting it looked into. It turned out to be lung cancer and I had to have my right lung removed. The original appointment was for a pulled muscle in my neck.

Since then I have had 180 radiation treatments with scans and x-rays done every 5th session. In my case they look mainly at the area of treatment but then look over the rest to see if any thing new has shown up.

I am British but live in the USA and have had all my treatment here. I am sure you radiologist will look over the whole scan/x-ray and basically feel you have nothing to worry about. Remember, he is not associated with your case, he will have just been given the documents and he makes the call, that way he is not influenced.

Hope this helps.

Cheers

KW

[hellsbrink]

Going by the scans I had on my spine, it all depends. I had a (private) MRI in the UK where they only concentrated on the discs and bones and gave basic info about the damaged disks and facet joints rubbing together, whereas a CT scan here in België resulted in a more detailed report including picking up what looked like arteriosclerosis. Oh, also had NHS x-rays in UK before the MRI where they said there was absolutely nothing wrong with my back whereas x-rays over here picked up even more things that weren't checked when the scans were done

Different scans/xrays/hospitals/radiologists, different results. They do seem to be somewhat more thorough in their investigations over here though.

[JohnRayner]

In the UK certainly, for a given request there'll be a clinical question to be answered (e.g. ultrasound liver for ? gallstones, CT brain for ?tumour), and the interpreting radiologist will have answering that question on their mind when reviewing the test. Having said that they will (or should) review all the data presented in the imaging, so e.g. an ultrasound of the liver is in fact an ultrasound abdomen and will contain images of the kidneys spleen bladder etc. An MRI of the spine for ? disc problems will yield info on the bones, muscles and nerves in that region, as well as info on the discs themselves.

Many a random cancer has indeed been picked up during imaging for an unrelated condition. And as pointed out, different radiologists/ doctors will interpret image findings a bit differently.

Cheers.

[obgraham]

The radiologist is a physician specialist, and ordering an imaging study is requesting their consultation. If I send you for a study, I indicate the problem, and briefly what I want them to look for, or what question I want answered.

In response, the radiologist will a)agree that the study I ordered was the appropriate one, or suggest a different study; b)write a report which hopefully will answer the question I posed; and c)indicate anything else which can be gleaned from the study, often unrelated to the question at hand. He/she will also review other "pertinent normals".

MANY times over the years I received a report of unrelated findings.

I highly doubt that the practice of radiology varies significantly between countries.

Finally, in the USA, they are vastly overpaid (!)

[Kerosine]

I had an x-ray done in South Africa for my class 2 medical and it came with a small note attached saying something to the effect of:

"The 2 shadows on the patients right upper lung are fingermarks from the radiologist. They are not in the patient."

Still makes me laugh.

In relation to the original question, I'm sure a radiologist will look at the scan even if they are not under obligation to.