A quality improvement initiative to reduce unnecessary follow-up imaging for adnexal lesions.

Our objective was to improve the quality of pelvic ultrasound reports and decrease the number of physiologic and benign adnexal lesions unnecessarily referred for follow-up. We performed a prospective cohort study of 2 quality improvement interventions: academic detailing with education for the ultrasound radiologists and sonographers, and implementation of a national consensus guideline on adnexal cysts. Our primary quality outcome measure was the proportion of pelvic ultrasound exams in which follow-up was recommended for an adnexal lesion.

Systematic approach to difficult problems in breast sonography.

Although there is an increasing use of more imaging modalities in breast imaging, the role of breast sonography has not diminished--in fact, the applications of sonography have increased with the improvement of high-frequency equipment. Compared with other breast imaging modalities, current sonographic equipment has excellent spatial resolution and outstanding image contrast. Furthermore, sonography does not have the disadvantages of other modalities such as magnetic resonance imaging including exposure to intravenous contrast, higher expense, patient claustrophobia, and potential adverse contrast reaction or renal damage.