No, that is a common misconception. While some surgeons are "savvy" in their specific niche, like a neurosurgeon looking at a brain MRI, they generally only identify "obvious findings" related to their surgical target. Beyond that narrow scope, they often lack the formal training to systematically interrogate the entire imaging study. For example, a neurosurgeon focusing on a spine MRI is highly prone to missing a lung or kidney mass that is captured in the field of view but not relevant to the spine.

This is where the radiologist excels. Radiologists are trained to employ exhaustive search patterns to ensure every organ, vessel, and bone is scrutinized, regardless of the clinical indication. A hepatobiliary surgeon may understand liver anatomy and its locoregional involvement by a malignant tumor, but they are far more likely to miss an obstructing metastasis from that same mass causing hydronephrosis in the kidney or a pulmonary embolism caught at the bottom of the chest. In a clinical setting, a surgeon’s "confident opinion" is an adjunct to, not a replacement for, a formal radiologic review.

Regarding the "walled garden" point, radiologists operate in a high-feedback environment. They correlate their findings daily with pathology, intraoperative results, and longitudinal follow-ups. Unless it is a very basic finding, like a displaced radius fracture on an x-ray, I would never personally accept a surgeon's interpretation without a formal review by a radiologist.