MRI reporting by radiographers: Findings of an accredited postgraduate programme

Abstract 

Aim

To analyse the objective structured examination (OSE) results of the first three cohorts of radiographers (n=39) who completed an accredited postgraduate certificate (PgC) programme in reporting of general magnetic resonance imaging (MRI) investigations and to compare the agreement rates with those demonstrated for a small group of consultant radiologists.

Method

Forty MRI investigations were used in the OSE which included the following anatomical areas and abnormal appearances: knee; meniscal/ligament injuries, bone bruises, effusions and osteochondral defects; lumbar spine: intervertebral disc morphology, vertebral collapse, tumours (bone and soft tissue), spinal stenosis and/or nerve root involvement; internal auditory meati (IAM): acoustic neuroma. Incidental findings included maxillary polyp, arachnoid cyst, renal cyst, hydroureter, pleural effusion and metastases (adrenal, lung, perirenal and/or thoracic spine). Sensitivity, specificity and total percentage agreement rates were calculated for all radiographers (n=39) using all reports (n=1560). A small representative subgroup of reports (n=27) was compared to the three consultant radiologists' reports which were produced when constructing the OSE. Kappa values were estimated to measure agreement in four groups: consultant radiologists only; radiographers and each of the consultant radiologists independently.

Results

The sensitivity, specificity and agreement rates for the three cohorts (combined) of radiographers were 99.0%, 99.0% and 89.2%, respectively. For the majority (5/9) of anatomical areas and/or pathological categories no significant differences (p<0.05) were found between the mean Kappa scores (K=0.47–0.76) for different groups of observers, whether radiographers were included in the group analysis or not. Where differences were apparent, this was in cases (4/9) where the variation was either not greater than found between radiologists and/or of no clinical significance. These results suggest therefore that in an academic setting, these groups of radiographers have the ability to correctly identify normal investigations and are able to provide a report on the abnormal appearances to a high standard. Further work is required to confirm the clinical application of these findings.

Keywords: Magnetic resonance imaging, Lumbar spine, Knee, Internal auditory meatus training, Agreement, Radiographer, Radiologist, Interobserver variation