Accurate diagnosis can depend upon the equipment used.
Similar Results At Wildly Different Cost
Unable to interpret the results themselves, for some physicians, an MRI is a figurative black hole into which a patient may be inserted to see what comes out. This often occurs without a definitive diagnosis. The hope is that the radiologist, or more importantly the examiner of the images, will rule out major illnesses. But using the wrong equipment can lead to inaccurate and costly conclusions.
Sometimes the terms CT and MRI are used interchangeably. What’s the difference between a CT scan and an MRI? Each machine may resemble a donut hole that encircles a patent. But which is better suited for locating cancers within the body?
This can depend upon where tumors may be located. Multiple Myeloma, for example is a bone cancer that shows up better in a CT (or CAT) scan since, much like a high-resolution x‑ray, it is best suited for bone injuries, lung or chest imaging, and detecting cancers. CT scans are widely used in emergency rooms because the procedure takes less than 5 minutes.
An MRI, on the other hand, can take up to 30 minutes. It excels in distinguishing soft tissues (i.e. ligament and tendon injury, spinal cord injury, brain tumors etc.). One advantage of an MRI is that it does not use radiation while CT scans do. This radiation is harmful if there is repeated exposure, so MRIs may be used to evaluate progress during a course of cancer treatment.
A PET scan uses nuclear medicine imaging to produce a three-dimensional 3D picture of functional processes in the body. PET scans provide metabolic information and are increasingly read alongside CT or MRI (magnetic resonance imaging) scans, which provide anatomic information.
Patient out-of-pocket costs vary considerably depending upon health plans. Pricing has declined dramatically over the years. Emergency room rates differ from hospital or outpatient prices. Insurance companies generally do not pay maximums. View monetary values merely as relative comparisons between various technologies.
Radiology Comparison Chart
How Accurate Is An MRI Report?
True or false? A false negative is when a test reveals favorable news that contradicts empirical evidence. Conversely, a false positive occurs when an incorrect unfavorable condition is reported. One might assume that results from a million-dollar piece of equipment would represent an authoritative conclusion.
Quality of the imaging coils put around the body part being scanned and the computer programs used to control the imaging and to analyze the images are important. But perfectly tuned equipment is only as reliable as the person who views the images and prepares the reports.
Statistics From Clinical Studies
Radiologist Emmanuelle Bouic Pagès, MD, and colleagues at CHU Lapeyronie, Montpellier, France, reported in the magazine Radiology that potential observer error existed in 47% of breast MRI studies performed from January 2005 to December 2010. Medscape clarifies that the many critics who came to the defense of the equipment may not have paid attention to the report content.
“Machines don’t make diagnoses; people do,” Herbert Y. Kressel, MD, editor of Radiology, explained to Medscape. “This is a study about errors made by people using the results of MRI exams.” Misinterpretation produced most of the false-positive results, according to the study.  With false-positive readings, a patient may undergo an unnecessary mastectomy or amputation.
It is hoped that the error rate is much lower wherever we might have tests performed. To determine if better resolution (higher Tesla) improves evaluation, a study by Grossman JW, et al. compared accuracy rates of 3-T and 1.5-T MRI in diagnosing medial and lateral meniscal tears in 200 patients. Fifteen of the 26 missed meniscal tears were not seen in retrospect even with knowledge of the tear type and location. The study concluded comparable accuracy of 3-T and 1.5-T MRI. 
A study by Akiko Shimauchi, et al. of 220 sequentially diagnosed breast cancer lesions found seven (3.2%) false negative results—considerably fewer than other published studies. Although the overall sensitivity of cancer detection was high (96.8%), it should be emphasized that a negative MRI should not influence the management of a lesion that appears to be of concern on physical examination or seen by other imaging methods. 
A negative MRI should not influence the care of a lesion.
Living up to his name, an orthopedic surgeon who blogs under the nom de plume Angry Othopod vents:
“Did you know that a growing number of doctors don’t even read the tests themselves? MRI is unnecessarily overused. In a study of 221 patients who had MRIs, the results showed that only 5.9% actually needed to have an MRI done.… If you suspect your doctor is just being quick or using MRI to reach that ‘aha’ moment, then you’re in a bad scenario.”
“When I order an MRI, I am 90% certain about what the results are going to show. Doctors need to have a clear-cut idea on what they can expect to see from the results. Next time you’re told to get an MRI, and your doctor has little clue to your diagnosis, you may want to get a second opinion. Also, be sure to ask the physician if they read the MRI themselves.” 
Unless it is of considerable volume, a mass detected on an x-ray, MRI, or CT scan is often a dot or speck requiring a judgment call. Determining whether a dot is an anomaly depends upon the skill, experience and alertness of the technician. Add these variables to the need for properly tuned equipment and you can see there is a margin for error.
”Advances in AI algorithms have narrowed the gap between computers and human experts in detecting breast cancer in digital mammograms,” Ioannis Sechopoulos, PhD, of Radboud University Medical Centre in Nijmegen, the Netherlands, and colleagues wrote.  If a radiologist reports back with positive results, get a second opinion. When results are negative, a second opinion is still advised.
- Critics Question Study's 47% Observer Error Rate for Breast MRI. medscape.com
- Comparison of the accuracy rates of 3-T and 1.5-T MRI of the knee in the diagnosis of meniscal tear. Grossman JW, De Smet AA, Shinki K. AJR Am J Roentgenol. 2009 Aug; 193(2):509-14.
- Breast Cancers Not Detected at MRI: Review of False-Negative Lesions. ajronline.org
- MRI overuse is widespread, and dangerous to patients. kevinmd.com
- AI Goes Head-to-Head With Radiologists in Mammography. medpagetoday.org
- Without limiting yourself to health, is there something else you would like to compare? The table content is provided by Diffen under Attribution-Noncommercial-Share Alike 3.0 United States.
- Human Images From World’s First Total Body Scanner. youtube.com
- How X-Rays See Through Your Skin. youtube.com
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