Lasting Partnership

Although at first glance radiology and pathology seem like an odd couple, they make an important partnership for patient care.

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Many famous pairings have graced the pages of history throughout the ages: Romeo and Juliet, Calvin and Hobbes, peanut butter and jelly… radiology and pathology? Although at first glance this might seem like an odd couple, imaging and pathology are an incredibly important partnership for patient care.

When interpreting radiologic images, radiologists may include a long list of possible diagnoses, because many kinds of lesions or tumors may initially appear the same on an image, says Mark D. Murphey, MD, FACR, AIRP Physician-in-Chief. However, by working closely with our pathology colleagues over many years at the AFIP and now the AIRP, you begin to notice consistent correlations between the radiologic and pathologic appearance of disease. An understanding of these patterns allows the radiologist to confidently limit your differential diagnosis, he says. “The better you are at limiting your differential and the more confident you become in your diagnosis, the greater the positive impact we as radiologists have on our patient’s management,” says Murphey.

Noticing the patterns between radiologic and pathologic images also helps your colleagues determine if a biopsy is necessary and where to biopsy the lesion. The more accurate this radiologic assessment, the easier it is to ensure the pathologist receives a representative tissue sample, Murphey adds. Radiologic-pathologic collaboration can also lead to other important opportunities, such as report standardization, clinical efficiency, and new research and innovations1.

Understanding radiologic-pathologic correlation is important — so important that ACGME has made it a requirement for residents. Many radiology residents get this training through the Four Week courses offered at AIRP. Nearly 200 practicing radiologists attend one of AIRP’s categorical courses to further their understanding of rad-path correlation. But what if you want radiologic-pathologic training on the go?

That’s where RAD-PATH Dx comes in.
RAD-PATH Dx is an interactive, case-based eLearning program. While reviewing cases, radiologists also have the opportunity to compare their findings and differential diagnoses to those of radiology and pathology experts. RAD-PATH Dx’s cases include review for up to eight subspecialties: breast, cardiac, gastrointestinal, genitourinary, musculoskeletal, neuroradiology, pediatric, and thoracic.

“RAD-PATH Dx not only reinforces what we teach at AIRP, but it also helps reinforce current radiologist training,” notes Murphey. “Being able to go through multiple cases at a time is one of the best ways to learn.”

And that’s not all — RAD-PATH Dx has plans to grow. According to Melanie McGraw, project manager for RAD-PATH Dx, cases will soon include an audio-visual component: video clips of radiologic-pathologic conferences during which the radiologist, radiology fellow or resident and pathologist review the various cases. During these conferences, each physician reviews the data and develops a differential diagnosis. In the video, the physicians discuss their respective findings and the potential differential diagnosis as well as the likelihood of these possibilities, both radiologically and pathologically. If they reach the same diagnosis individually, it is more than 99 percent likely the correct diagnosis, says Murphey. It is important to remember that our patient’s treatment and outcome can only be optimized if we begin with an accurate initial diagnosis.

Endnote
1. Sorace J, et al. Integrating pathology and radiology disciplines: an emerging opportunity? BMC Medicine. 2012 Sep;10(100):1–6.

Musculoskeletal Imaging Categorical Course

October 15-19, 2018

Examine the pathologic basis behind all aspects of musculoskeletal disease — including trauma, neoplasm, infection, arthritis and more.

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