The Radiology Expert Witness Guide

Wendy Ketner, M.D.

Written by
— Updated on June 25, 2020

The Radiology Expert Witness Guide

Radiology expert witnesses are trained to use medical imaging to diagnose pathology that cannot be confirmed with physical exam alone. Selective subspecialties of radiologists, such as Interventional Radiologists, treat diseases as well. Radiology experts perform and evaluate x-rays, computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, positron emission tomography (PET), fusion imaging, and ultrasounds.

In medical malpractice or personal injury cases, attorneys can retain a radiology expert witness to review and opine on a plaintiff’s imaging for a variety of injuries and diseases. In some cases, a radiology expert will be asked to perform a blind read to confirm whether or not imaging was misread.

Radiologists are frequently retained to discuss liability. This can involve determining whether an image was read incorrectly leading to damages or whether an interventional radiologist incorrectly performed a procedure. For instance, if a radiologist performing a CT-guided biopsy of a lung nodule hit the liver and didn’t recognize bleeding, leading to the patient’s death. Radiologists can also be called to opine on causation. For instance, a radiology expert witness could explain how a brain tumor might have caused personality changes.

Cases That Could Benefit From Radiology Expert Assistance

Radiology expert witnesses are particularly helpful for cases involving delayed or missed diagnoses following an imaging study. For example, a radiology expert may render an opinion on imaging records deemed “suspicious” for cancer, images used to diagnose traumatic brain injuries, or the standard of care for administering various imaging studies. Any case involving misread imaging that led to delayed or no intervention could benefit from the opinion of a radiology expert.

In a personal injury case, for example, in which a car accident leaves the plaintiff with injuries that require medical imaging, a radiology expert witness may be helpful in diagnosing the plaintiff’s injuries and assessing the extent of the damages sustained.

The Radiology Expert Report

Radiology expert witnesses write reports of their reads to either confirm or contradict the defendant radiologist. They might write reports for causation and can be called to testify the same as other experts. Radiology experts may consult with attorneys helping them understand anatomy and pathology. For instance, understanding the anatomy involved in embolization of a brain arteriovenous malformation.

Deciding Which Radiology Expert You Need

Ultimately, when selecting a radiology expert witness for your case, it’s essential to use the case facts as guidance. In a medical malpractice matter, your radiology expert witness’ specialty should match that of the defendant radiologist as closely as possible. This will increase the chance that your expert will be deemed qualified to opine on the issues at hand by the court. In a personal injury matter, your radiology expert witness should be one that frequently sees and diagnoses such injuries. For instance, diagnosing pack injuries after a motor vehicle accident.

Here are a few of the common radiology subspecialties and what types of injuries and diseases they attend to.

Interventional Radiology

Interventional radiologists use minimally-invasive image-guided procedures to diagnose and treat diseases. Interventional radiologists typically handle diseases and injuries of the  vascular, gastrointestinal, hepatobiliary, genitourinary, pulmonary, musculoskeletal, and the central nervous system. Therapies include embolization, angioplasty, stent placement, thrombus management, drainage, and ablation, among others.

Diagnostic Radiology

A diagnostic radiologist uses x-rays, radionuclides, ultrasound, and electromagnetic radiation to diagnose disease.


Neuroradiologists interpret x-rays, MRIs, and CT scans to diagnose abnormalities of the brain, spine and spinal cord, face and neck, and peripheral nerves. They also perform angiographic studies of the brain and spine and interpret the findings.

Nuclear Radiology

Nuclear medicine radiologists use radioactive materials (radiopharmaceuticals) to diagnose and treat disease. These radiopharmaceuticals are typically injected into a patient’s vein. Nuclear radiologists treat hyperthyroidism, thyroid cancer, solid tumors, hematologic malignancies, or painful bone metastases. They can also use nuclear tagged red blood cells to identify bleeding.

Pediatric Radiology

Pediatric radiologists use imaging and interventional procedures to diagnose diseases particular to infants and children. Pediatric radiology expert witnesses may be called to review imaging from plaintiffs with congenital abnormalities or those who suffered from injuries or diseases in childhood that caused impairments in adulthood.

Musculoskeletal Radiology

Musculoskeletal radiologists are specially trained to diagnose conditions that affect the bones, joints, and soft issues in the extremities.

Key Considerations When Retaining a Radiology Expert

The best radiology expert witnesses are ones who have been practicing for a long time and who are both confident and definitive. For lawyers retaining a radiology expert to opine on liability, it is important to match the expert’s credentials exactly to the credentials of the defendant radiologist. Since the field of radiology continues to become more specialized, it’s imperative that your expert have all the relevant training and experience to opine on the specifics of the issue at hand.

Experience in the courtroom is also a plus in difficult cases much the same as it is with any other specialty in which the expert needs to hold steadfast during cross examination.

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