Guide · checked October 2026
Radiology peer review explained
Radiology peer review is the review of studies that have already been reported, by another radiologist, to check the interpretation; the RCR describes it happening during routine reporting, when preparing for multidisciplinary meetings, or as an ad hoc second opinion, with the learning fed back to the original reporter.
Peer review, peer feedback and REALMs
The RCR's Standards for radiology events and learning meetings (2020) defines peer review as reviewing previously reported studies, and peer feedback as telling a colleague about an outcome. It says peer feedback should continue alongside radiology events and learning meetings (REALMs), and that cases reach the REALM chair from several routes, including department QA programmes, double reporting and second looks at MDT meetings.
The Quality Standard for Imaging 2026 (XR-706) expects a service's imaging reporting policy to cover peer review of reporting and access to a second opinion.
Setting up a programme
- Decide how cases are chosen: random sampling of reported studies, targeted review (for example a modality or a new reporter), or review of priors met during routine reporting.
- Decide who reviews: a peer with the right subspecialty, never the original reporter.
- Decide whether reviewers see the original reporter's name. Blinding reduces bias in both directions.
- Decide whether and how to score. ACR RADPEER uses a scored scale; the RCR does not recommend scoring in REALMs.
- Keep the process separate from disciplinary and legal processes, as the RCR asks for REALMs, so people engage honestly.
What to measure
Track reviews completed against the plan, the share of reviews with a discrepancy, how many were considered clinically significant, and how long cases wait for review. Use the numbers to target learning, not to rank individuals publicly.
What peer review is not
- Not double reporting: peer review happens after the report is issued.
- Not a performance league table: the RCR stresses learning without blame.
- Not proof of accuracy: a sample shows patterns, not every miss.
Where RadQA fits
RadQA's peer review module selects studies for routine review by deterministic sampling (a stable hash of the study, at a percentage you set, 5% by default), can always sample named radiologists, and never assigns a reviewer their own case. Reviewers can be blinded to the original reporter on every screen, including what the assistant can see. Scores use a RADPEER-style scale and feed an analytics view of discrepancy rates.
RadQA can also flag possible discrepancies between a current report and the most recent comparable prior, for a person to review. RadQA is a pilot. It is a quality-assurance assistant, not a diagnostic device, and it does not replace radiologist reporting or clinical judgement.
Questions
What is the difference between peer review and peer feedback?
In the RCR's 2020 standards, peer review is reviewing previously reported studies; peer feedback is telling a colleague about an outcome.
Should peer review be blinded?
There is no single rule in the RCR documents cited here. Many departments blind the original reporter to reduce bias, and RadQA supports this.
Sources
Official pages, checked October 2026. Guidance changes, so check the current version before you rely on it.
General information for healthcare managers and clinical teams, checked October 2026. It is not legal, regulatory or clinical advice; follow the current official guidance and your organisation's own policies. No patient data is used in these examples. RadQA is a quality-assurance assistant for imaging departments. It is not a diagnostic device and does not replace radiologist reporting or clinical judgement. Validate against your own systems and local governance before production use.