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  • Radiologist assessment of orbital lesions match histopathology only half of the time

    Comprehensive Ophthalmology, Oculoplastics/Orbit

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    Review of: Clinical correlation recommended: accuracy of clinician versus radiologic interpretation of the imaging of orbital lesions

    Bacorn C, Gokoffski K, Lin L, et al. Orbit, April 2020

    In this study, clinical and radiologic assessments of orbital lesions were compared against histopathologic diagnosis for concordance. 

    Study design

    This retrospective review assesses histopathologic outcomes after orbitotomy and compared the results with surgeons' and radiologists' assessments of imaging features and differential diagnoses. Charts of 242 patients who underwent orbitotomy from 2000 to 2019 were examined in this study. Of these, 185 documented the clinician’s clinical impressions, the radiology report and the histopathology report.

    Outcomes

    Clinicians correctly assessed the nature of lesions in 76% of specimens, whereas radiologists were correct in 52%. The final histopathology agreed with both the clinical impression and radiology report in 49% of cases. Clinicians have the benefit of a detailed history and thorough examination, thus favoring an accurate diagnosis.

    Limitations

    The study is limited by its retrospective nature. The distribution of pathology reflects the referral pattern to an academic tertiary care which may vary at other centers.

    Clinical significance

    Clinicians are uniquely trained to assess orbital imaging features. This study underscores the importance of reviewing scans personally; clinicians should not solely rely on reports. The imaging features must be juxtaposed against the clinical and medical facts.