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(Radiology. 2001;218:603.)
© RSNA, 2001

Letters to the Editor

Variations in the Quality of Lumbar Spine MR Imaging in Washington State

David C. Levin, MD

Department of Radiology, Thomas Jefferson University Hospital, 111 South 11th Street, Philadelphia, PA 19107, e-mail: david.levin@mail.tju.edu

Editor:

I read with interest the article by Dr Jarvik and colleagues in the May 2000 issue of Radiology (1) dealing with variations in the quality of lumbar spine magnetic resonance (MR) studies in the state of Washington. They referenced earlier work of a similar nature by my colleagues and me (2) at Thomas Jefferson University Hospital, Philadelphia, Pa, which was carried out with researchers from Pennsylvania Blue Shield, Camp Hill. However, the article by our group that they cited as their first reference (2) is incorrect. That particular article had nothing to do with MR image quality. The article that should have been cited was written by Friedman et al (3). Perhaps the confusion arose because both articles originated in our department and included a group of co-authors from Pennsylvania Blue Shield. Readers who may want to refer to our earlier publication discussed by Dr Jarvik and colleagues should therefore refer to that of Friedman et al (3).

One other point should be corrected. Dr Jarvik and colleagues state that our study did not address the relationship between MR quality and either the number of studies performed at a particular site or the field strength of the magnet used. Our study (3) did address how these two variables are related to image quality. We found a statistically significant association between unsatisfactory ratings for quality and both the use of low-field strength (<=0.6 T) MR units and a lower median monthly procedure volume.

REFERENCES

  1. Jarvik JG, Robertson WD, Wessbecher F, et al. Variation in the quality of lumbar spine MR images in Washington State. Radiology 2000; 215:483-490.[Abstract/Free Full Text]
  2. Levin DC, Edmiston RB, Ricci JA, Beam LM, Rosetti GF, Harford RJ. Self-referral in private offices for imaging studies performed in Pennsylvania Blue Shield subscribers during 1991. Radiology 1993; 189:371-375.[Abstract/Free Full Text]
  3. Friedman DP, Rosetti GF, Flanders AE, et al. MR imaging: quality assessment method and ratings at 33 centers. Radiology 1995; 196:219-226.[Abstract/Free Full Text]

Drs Jarvik and Deyo respond:

Jeffrey (Jerry) G. Jarvik, MD, MPH and Richard A. Deyo, MD, MPH

Departments of Radiology* and General Internal Medicine, University of Washington, 1959 NE Pacific Street, Box 357115, Seattle, WA 98195, e-mail: jarvikj@u.washington.edu

We thank Dr Levin for pointing out the error in our citation. He is indeed correct that we should have also cited the article by Friedman et al (1). That Friedman et al found a statistically significant association between lower quality and both low field strength and low monthly volume of procedures supports our conclusions. We would certainly agree with their conclusions that their results and ours indicate the need for programs to monitor the quality of MR imaging, as has been instituted by the American College of Radiology with their Magnetic Resonance Imaging Accreditation Program.

REFERENCES

  1. Friedman DP, Rosetti GF, Flanders AE, et al. MR imaging: quality assessment method and ratings at 33 centers. Radiology 1995; 196:219-226.




This Article
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