A radiology report will include the impression at the end of the report and at times, a recommendation for further testing. Often this will be an additional imaging test to either follow an abnormality or confirm the suspected diagnosis. At times, the radiologist will even recommend specialty doctor consultation or non imaging tests to confirm a diagnosis.
The radiologist is a specialist physician consultant of imaging. As such, he uses his expertise to guide the physician who ordered the imaging study to the most precise diagnosis. At times, this requires further testing and imaging. The radiologist will recommend further testing which has the highest probability of confirming the diagnosis.
The ordering physician has a lot more information about the patient then the radiologist. The ordering physician will know the clinical history, he has examined the patient, has information about any specialty consults, family history, lab results, etc. Therefore, the ordering clinical physician will decide whether the recommended further testing is needed.
Sometimes, the ordering clinical physician will already have a strong suspicion for a diagnosis before the imaging is ordered. In these cases, imaging is used to confirm the suspicion. In other cases, the ordering physician has no idea and is trying to find a diagnosis based on your symptoms. In some cases, the imaging doesn’t explain your symptoms so the ordering physician may have to order additional non imaging testing.
The ordering clinical physician does not have to order the tests that the radiologist recommended. There are cases where the ordering physician already knows the diagnosis or is confident based on other information. Sometimes, the finding on imaging and recommendations has little to do with the patient’s symptoms and the ordering physician will instead pursue testing that will explain the patient’s symptoms.
Therefore, it is not too unusual for a radiologist’s recommendations for further testing to not be done. Ultimately, the clinical ordering doctor has to decide based on all the information that is available. At times, the recommended tests have already been done at another hospital. At other times, they are not needed to explain your symptoms or get to the diagnosis.