PACS: effect on incidental findings

Previous studies have addressed the increased volume of incidental findings when interpreting MRI lumbar spine studies after the implementation of a picture archiving and communication system (PACS). The purpose of this study is to confirm prior findings and contribute additional knowledge that supports the use of technology in complimenting the quality of patient care. Lumbar spine interpretations were reprinted from 900 studies and individually reviewed. These lumbar spine studies were performed on a 1.5-tesla magnet. Included were 300 consecutive lumbar spine reports over a two year period: four months prior to PACS introduction, four months during the transition to PACS, and four months post PACS implementation. Reports stating incidental findings were tabulated, along with the frequency patient gender, age, location (outpatient, inpatient or emergency room), reporting radiologist, specific finding and radiologist recommendations in each case were documented. The number of incidental findings increased from five pre-PACS to nine during the transition phase to PACS, followed by 11 post-PACS. This results in a maximum increase of 120 percent from pre- to post-PACS. The most common incidental findings include renal mass, cyst or lesions, aortic aneurysms and lymph node abnormalities. Statistical data confirms that the implementation of PACS into a radiology practice for MRI lumbar spine imaging appears to have a beneficial impact on the number of reported incidental findings and recommended follow-up studies.