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Interpretation and reporting of CT colonography

Health and Disability Commissioner Anthony Hill today released a report finding a diagnostic radiologist in breach of the Code of Health and Disability Services Consumers’ Rights (the Code) for failing to correctly interpret a man’s computed tomography (CT) colonography scans.

A man in his sixties, with a family history of bowel cancer, was referred for a CT colonography. On analysing the images, a radiologist could not reach a conclusion about a mass in the bowel, and asked another radiologist for a second opinion.

The second radiologist reviewed the images and concluded that the mass was retained faecal material. While not dismissing the possibility of a tumour, his final opinion to the first radiologist did not reflect this, and he did not provide a differential diagnosis for his colleague to consider.

The first radiologist reviewed the scans, accepted his colleague’s opinion, and reported the results as normal and recommended a follow-up ultrasound in five years’ time. Approximately two years later, the man became unwell and was diagnosed with metastatic bowel cancer.

Mr Hill considered that the failure to correctly interpret the scans together with a lack of further investigation comprised a significant departure from the accepted standard of care by the second diagnostic radiologist and found him in breach of the Code.

Mr Hill said that by not noting that the differential diagnosis of a possible lesion or recommending further testing he considered that, in effect, the second radiologist did not leave open the possibility of a tumour.

Mr Hill recommended that the second diagnostic radiologist apologise to the man, complete further training, and carry out an audit of previous CT colonography cases.

The full report for case 17HDC02239 is available on the HDC website.


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