Gynaecologist admits to inexperience with MRI scan images

A gynaecologist who has been accused of professional misconduct for performing a surgical procedure without waiting for a report on a magnetic resonance imaging scan yesterday admitted he had little experience with such medical images.

Duncan Leung Sau-sun is also alleged to have operated on patient Yvonne Tsang Yee-wan to remove an ovarian cyst on December 2, 2003, 'when he did not have proficiency in interpreting the MRI films'.

At a Medical Council disciplinary hearing yesterday, Dr Leung said he had studied radiology at Queen Mary Hospital from 1991 to 1992 but was not taught about MRI, only the computed tomography scan (CT scan).

He also told the council that he read MRI films just occasionally, not as often as he read CT scan images.

Dr Leung said he thought there was a dermoid cyst, also known as ovarian teratoma, on the left side of Ms Tsang's ovary after an ultrasound test on November 26, 2003.

Ms Tsang had the MRI scan when she was admitted to the Hong Kong Sanatorium and Hospital, one day before the operation.

Dr Leung said he had received the MRI film about four hours before the surgery. He had shown the film to Ms Tsang and told her what was going to be taken out.

But Ms Tsang testified in a hearing last June that Dr Leung had shown her the film from the MRI scan the previous evening, without going into details.

Veteran radiologist James Chan Chi-sang said at the same hearing that no dermoid cyst substance was found based on the findings of the MRI scan, only a cyst.

Expert witness, Queen Mary Hospital's obstetrics and gynaecology consultant Pun Ting-chung, said had he been in Dr Leung's position he would have waited for the MRI report or asked radiologists to help interpret the images unless the patient's symptoms were deteriorating.

Dr Pun said in Ms Tsang's case the surgery could have been put off for one to two days.

Another expert witness, Union Hospital's obstetrics and gynaecology specialist Ares Leung Kwok-ling, agreed that there was no medical urgency to perform the laparoscopic procedure in Ms Tsang's case.

Dr Leung said he had explained to the patient about the risks, merits and nature of the operation on November 26, 2003, and Ms Tsang gave a verbal agreement on the surgical treatment that day and signed a consent form at the hospital on the eve of the surgery.

The case will continue next month.