Additional Orbital Imaging Recommended in 0.2% of Head/Neck Reports; High Pathology When Followed

Just 0.2% of head/neck CT and MRI reports recommended dedicated orbital imaging. When performed within 1 year (34% adherence), 93% of follow-up exams showed pathology, most commonly neoplastic.

• Among 60,543 head and neck CT/MRI reports, only 133 (0.2%) contained a recommendation for additional orbital CT or MRI.
• Follow-up orbital imaging occurred in 34% (45/133) within 1 year; 93% (42/45) of those exams revealed pathology (62% neoplastic, 22% inflammatory, 16% infection/traumatic/vascular).
• The high pathology yield may partly reflect planned surveillance rather than direct consequence of the radiologist's recommendation, as acknowledged by the authors.

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