CT scans vs. MRI scans: Can a radiology error turn your life upside down?

by | Nov 18, 2021 | Medical Malpractice, Failure to Diagnose, Misdiagnosis | 4 comments

Overview

Modern medical equipment is a lifesaver in giving appropriate therapy to patients. Following the development of radiology studies such as CT scans and MRI scans, physicians can precisely detect complicated issues inside the human body. Though many innovations are done consistently, misdiagnosis errors are unavoidable when considering CT scans vs. MRI scans.

According to a study published in 2019 in the Journal of the American Medical Association, there is a significant increase in the use of imaging studies from 2000 to 2016. Around 136 million imaging studies were done in adults and older adults. However, there was a drop in the studies done on child patients. Even though many physician groups are against the excessive use of CT scans and MRI scans, the trend is escalating.

Radiologist Leo Henry Garland (1903–1966) was a pathfinder in analyzing the diagnosis errors in radiology. He had done various analyses and found that even the most experienced radiologists could also make errors while comprehending and interpreting the radiology images. Various experts’ studies have helped reduce the errors in the most complex and error-prone imaging studies.

Here, we’ll probe at the procedures, applications, and errors of CT scans vs. MRI scans, as well as how misdiagnosis might exacerbate your pain and end up in medical malpractice lawsuits.

CT scans vs. MRI scans

CT scans and MRI scans differ in their usage. Computer Tomography Scan or CT scan is the most sought-after medical diagnostic technology to get detailed images of muscles, bones, organs, and blood vessels. At the same time, Magnetic Resonance Imaging or MRI is also non-invasive imaging used to get a more comprehensive picture of internal organs, tissues, and nerves.

Image-of-a-ct-scan-diagnose-errors-in-ct-scans-vs-mri-scans

How the patient undergoes the procedure also changes in CT scans vs. MRI scans. In a CT scan, the patient has to lie down on a tube-like machine, and it rotates to take the series of images. MRI machine has a more closed structure, making people with claustrophobia uncomfortable as they have to be inside for a long time. Moreover, the MRI machine produces more noise.

CT scans vs. MRI scans vary in the use of the medium to capture the imaging. A CT scan or CAT scan uses multiple X-rays to various cross-sections of the body, and the computer assembles all the cross-sectional images and creates 3-D images. However, an MRI scan uses a powerful magnetic field to make the protons in the human body align with it. When the radio wave frequency is applied to the machine, the protons will work against the pull of the waves. When the waves are turned off, there will be a realignment of the protons. The time taken for that by the tissues will detect the defects in them.

The time taken for the procedure differs in CT scans vs. MRI scans. A CT scan can be done in the shortest time, a maximum of 10 minutes. Whereas, for an MRI scan, the patient should be inside the machine for more than 45 minutes.

In the case of an injured patient, a CT scan is ordered to diagnose the severity of his injuries and decide the plan of treatment, surgery, or other procedures. Since it produces a series of images of all the possible slices of the scanned part, it will be easy for the radiologist to see the injury in detail. MRI scans give clearer images of injuries in the spinal cord, nerves, muscles, tendons, ligaments, brain, knee, or shoulder.

While doing a CT scan, if needed, a contrast dye will be injected or given orally to the patient to get highlighted images of blood vessels, organs, or inner parts of the body. In case of getting contrast dye imaging, discuss your allergies or other health issues with the radiologist. During an MRI exam, dialysis patients are instructed to use gadolinium agents only if it is inevitable. However, they have to do dialysis to remove the agent entirely from the body as early as possible after the scan.

The risk of radiation is more when comparing CT scans vs. MRI scans.  The ionizing radiation used during the CT scan is more than that of a normal X-Ray. The smaller amount of radiation from CT scans will not do much harm to people. However, prolonged exposure to ionizing radiation can lead to an increased possibility of cancer. People with metal implants like metal plates, pacemakers, nerve stimulators, defibrillators, loop recorders, cochlear implants, etc., should not undergo MRI scans as the magnetic field will have adverse effects on them.

The adverse effects of CT scans vs. MRI scans vary. As a CT scan is harmful to the fetus and can cause congenital disabilities, pregnant women or those who suspect pregnancy should inform the physician and radiologist about that. Pregnant women should avoid MRI scans only in the first trimester.

Common diagnosis errors the radiologists make

Misdiagnosis means making some errors in diagnosing the medical condition of the patient. The radiologist’s misdiagnosis could be a setback for the patient to get proper treatment, and he would end up in coma or death. Failure to note down some minute findings in the CT scans or MRI scans is known as underdiagnosis. This also could delay the appropriate and emergency care for the patient.

Every year, more than 40 million radiological misdiagnoses are recorded worldwide. Despite the invention of innovative technologies in diagnostic imaging studies, such errors could not be bridled. The inability to diagnose radiological images will potentially accelerate the damages to the patient.

Let’s explore the different kinds of errors that could arise on the part of the radiologists in diagnosing disease conditions in CT scans vs. MRI scans. Renfrew classification and Brook classification had laid out the causes for the occurrences of imaging study errors.

Renfrew classification has listed out 12 types of diagnosis errors from the part of the radiologist as given below:

  • Due to complacency, the deficit is found but related to something else
  • Due to faulty reasoning, the abnormality found is attributed to something else
  • Due to lack of knowledge, the abnormality is related to the wrong cause
  • Missing abnormality, which could be discernible in revision
  • Abnormality is not communicated to the concerned physician
  • Abnormality could not be identified due to the poor quality techniques applied
  • Failing to consider prior imaging studies
  • Due to incomplete patient medical history, the abnormality can be missed
  • Abnormality can be missed as it is outside the considered area.
  • Missing an additional abnormality as being satisfied with one finding
  • Error due to complicated procedures
  • Relying blindly on the previous imaging report

Brook classification takes into account the technical errors too, along with the radiologist’s errors. They are listed as:

  • Human errors such as errors in diagnosis and interpretation, use of complicated procedures, and the involvement of more than one person.
  • Technical errors such as system errors
  • External elements like power failures
  • Errors from the part of patients like not obeying the instructions or others who are not familiar with the imaging procedure

How to restrict radiology errors?

While analyzing the prominent causes of misdiagnosis errors in CT scans vs. MRI scans, let’s place them under three categories to find solutions to keep them under check.

Perception errors

Perceptual errors from the radiologists occur in the initial stage of reading the radiology images. Fatigue is the main reason that could impact the errors on the part of the radiologists. The radiologists are working in lengthy shifts as there is an influx of imaging studies to be done and reviewed in a short time. According to a study, a radiologist gets only 3 to 4 seconds to review an imaging study. Workload and fatigue influence the performance of the radiologist in visual perception and diagnosis.

Radiologists should be given adequate break time to relax and refresh their minds to concentrate more on their reading images. Frequent quality checks at the department level and team meetings on recurring errors will mitigate them.

Artificial intelligence (AI) can be used to restrict perception errors. The AI algorithms read even voluminous imaging studies with complexities and recognize the abnormalities in a short span giving more or less qualitative reports. Modern advancements and powerful computing machines in AI research have been a boon to radiology where perception errors are inevitable.

Another method used to constrict the diagnosis errors is second or double reading. Reading the radiology diagnosis by a sub-specialist would definitely lessen the possible discrepancies that could arise from the initial report. However, a second reading is a time-consuming process, and that could also lead to conflicting opinions. When we consider CT scans vs. MRI scans, a second reading can be implemented to confirm the finding in risky imaging studies.

Interpretive errors

While interpreting the neuroimaging studies, the radiologists follow heuristic techniques to assess the complex findings in understandable formats. A biased approach to a diagnostic study would lead the radiologist to do misdiagnosis or underdiagnosis. Approaching a study with a predisposed mindset would make the radiologist overlook an abnormality other than the one he was expecting.

Inadequate knowledge, failing to attribute findings to appropriate causes, complicated procedures, and blind reliance on prior findings and comparison to prior MRIs or CTs could lead to misinterpretation of findings.

The metacognitive psychological approach can be used to reduce interpretive errors. Radiologists should be skeptical during the review and analyze what had led to the abnormality in the finding. Using checklists to avoid missing common findings would be a reminder and restrict the diagnosis errors.

Communication errors

According to National Center for Biotechnology Information, around 38% of the 380 communication errors in radiology directly affected the patient’s care. Failure to communicate the abnormalities in the imaging studies to the treating physician can exacerbate the patient’s condition to something fatal.

Suppose the patient’s past medical history and imaging studies come in handy to the radiologist from the treating clinician, he can be clear and vigilant as he knows what all can be expected and what should be concentrated in the CT scans or MRI scans.

Communication error can be from the part of the descriptor while inferring the diagnosis and recording into the report. Defects in the communication medium could transfer false data and end up harming the patient. Therefore, effective transmission of diagnosis to the treating physician is inevitable in deciding proper treatment plans and constructive progress in the healing process. Illegible handwritten imaging reports could mislead the treating physician and lead to wrong treatment.

Misdiagnosis and medical malpractice

Are you in a dilemma whom to sue for your suffering caused by a radiology misdiagnosis? You can definitely file a lawsuit against the radiologist who failed to diagnose a critical health issue or misdiagnosed one issue as another. Studies state that more than 30% of radiologists are sued at least once in their practice time. In most of the cases where the radiologists are sued, the reason would be underdiagnosis or misdiagnosis.

When we compare the first lawsuits in CT scans vs. MRI scans, we can understand the difference. The first lawsuit was filed for a CT misdiagnosis, 8 years after the invention of it in 1982 whereas in 4 years after the introduction of MRI exams, the first lawsuit was filed in 1987. This fact shows that with the improving technology, the possibility of errors is also on the rise.

Since the imaging studies involve complexities, mild errors cannot be evaded. However, when a major error occurs due to the negligence of the radiologist ending in irreparable damages to the patient, there arises the necessity for a medical malpractice lawsuit. In the U.S health care setting, diagnostic errors are 14% and surpass the medication error, which is just 9%.

CT scans vs. MRI scans lawsuits

How could misdiagnosis tumble one’s life upside down? Let’s see a few examples where people’s destinies were rewritten due to radiology errors.

Image-of-a-mri-scan-diagnose-errors-in-ct-scans-vs-mri-scans

A man who had cancer on his spine was treated with surgery and chemotherapy and was recovering. CT scan was done to monitor the healing as well as the possibility of regrowth of cancer cells. The radiologist ignored a very small lump and declared the CT as normal. When the next CT was done after a few months, the lump had doubled in size. The subsequent surgery could not protect him from permanent disability.

In another case, a 60-year-old woman underwent a cervical MRI. She was allergic to certain medications. Though she had informed the technician about the allergic issues, she was injected with contrast dyes. The woman had breathing trouble, tachycardia and ended up in cardiac arrest and death.

These examples show how tragic a simple misdiagnosis or other radiology errors could toss the people’s lives upside down. However, the only hope that was left to the victims was lawsuits. In the first case, the victim received $5,000,000 as restitution, whereas in the second case, the victim’s family was awarded $7,000,000 as compensation for wrongful death.

If you are affected by a medical error from your radiologist, seek the help of a medical malpractice attorney to sue the radiologist.

Final Thoughts

Radiology errors in CT scans vs. MRI scans cannot be overlooked as the imaging studies have vital roles in diagnosing the health issues and planning the treatment course. Delayed diagnosis or missed diagnosis can lead to irretrievable damages to the patients. The affected victims can pursue medical malpractice claims against the radiologist.

Expert witnesses use their experience and knowledge in deciding if a radiologist had diagnosed a deficit even before the imaging study report is made. The degree of disability or injury caused by the misdiagnosis would decide if the radiologist was negligent. A well-experienced medical malpractice lawyer could lead the victims through the complex litigation process.

With the innovative inventions in radiology, incessant efforts are made to mitigate the frequency of errors in reading imaging studies. Radiology reports cannot be error-free for 100 percent but the errors could be considerably curbed if more care and expertise are used.

4 Comments

  1. Marshall Dave

    That’s a very good observation. Radiation is always going to be dangerous to our body. False information and errors in radiology reports will lead to a wrong medication.Its an eye opener to understand in such circumstances.Terrific job.

    Reply
  2. Lorenz Heister

    CT scans and MRIs are common, noninvasive medical imaging techniques used to see what’s happening inside the body. No one says that you should avoid a CT scan or other imaging test if you . That was the first mistake. And when does an MRI have a life-saving or life-changing impact? Does this patient suffer from chronic medical conditions? Nonetheless, it’s a very useful post for all of the victims.

    Reply
  3. Jerry Collymore

    It elucidates the significance of the radiologist. It clearly explains if a radiologist missed any findings, we can’t predict the complications. Thanks a billion.

    Reply
  4. Ryan Thomas

    Thank you so much for sharing this wonderful information. MRI excels in showing certain diseases that a CT scan cannot detect. Yes, it is true, the delayed diagnosis or missed diagnosis can always lead to irretrievable damages to the patients. So it is better to have a second opinion on radiology studies and treatments.

    Reply

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