Comparing the Interpretation of Diffusion-Weighted Magnetic Resonance Images Made by Emergency Physicians and On-Call Radiologists

Abstract

Aim: Stroke is a leading cause of adult disability and death worldwide. It is very important to determine the ischemic tissue at risk in stroke patients. Although brain computed tomography (CT) is the first and standard imaging technique, diffusion-weighted magnetic resonance imaging (DW-MRI) is superior to CT and is the optimal imaging technique for the diagnosis of acute ischemic stroke. In our study, we aimed to compare the interpretation of DW-MRI between emergency physicians (EP) and on-call radiologists (OCRs). Materials and Methods: This multi-centered, prospective study was conducted at three central hospitals from June 1, 2016 to May 31, 2017. DW-MRI images of the patients were first interpreted by the EP and then by the OCR. Finally, DW-MRI images were interpreted by a definitive result team comprised of two radiologists who were blinded to the study. Sensitivity, specificity, positive predictive value, negative predictive value, and. coefficient were calculated. Results: In total, 315 patients' DW-MRI images were examined. The interpretation sensitivity and specificity rates of the DW-MRI images for EPs were 95.1% and 98.7%, respectively, whereas those for OCRs were 98.8% and 98%, respectively. There was almost perfect agreement (kappa value > -0.80) regarding DW-MRI interpretations of both OCRs and EPs. Conclusion: Our study showed that EPs were very successful in interpreting DW-MRI after a short-term training.