Management of Incidental Pulmonary Nodules: Influencing Patient Care Through Subspecialized Imaging Review.

Autor: Escalon JG; Department of Radiology, NewYork-Presbyterian/Weill Cornell Medicine, New York, NY. Electronic address: joannagescalon@gmail.com., Sullivan D; Department of Radiology, NewYork-Presbyterian/Weill Cornell Medicine, New York, NY., Pua BB; Department of Radiology, NewYork-Presbyterian/Weill Cornell Medicine, New York, NY., Girvin F; Department of Radiology, NewYork-Presbyterian/Weill Cornell Medicine, New York, NY., Verzosa Weisman S; Department of Radiology, NewYork-Presbyterian/Weill Cornell Medicine, New York, NY., Steinberger S; Department of Radiology, NewYork-Presbyterian/Weill Cornell Medicine, New York, NY., Toy D; Department of Radiology, NewYork-Presbyterian/Weill Cornell Medicine, New York, NY., Groner L; Department of Radiology, NewYork-Presbyterian/Weill Cornell Medicine, New York, NY., Legasto AC; Department of Radiology, NewYork-Presbyterian/Weill Cornell Medicine, New York, NY., Gruden JF; Department of Radiology, NewYork-Presbyterian/Weill Cornell Medicine, New York, NY.
Jazyk: angličtina
Zdroj: Current problems in diagnostic radiology [Curr Probl Diagn Radiol] 2022 Jul-Aug; Vol. 51 (4), pp. 524-528. Date of Electronic Publication: 2021 Dec 02.
DOI: 10.1067/j.cpradiol.2021.11.004
Abstrakt: Objective: To evaluate whether thoracic radiologist review of computed tomography-detected incidental pulmonary nodules initially reported by non-thoracic imagers would change management recommendations.
Materials and Methods: The Radiology Consultation Service identified 468 computed tomography scans (one per patient) performed through the adult emergency department from August 2018 through December 2020 that mentioned the presence of a pulmonary nodule. Forty percent (186/468) were read by thoracic radiologists and 60% (282/468) were read by non-thoracic radiologists. The Radiology Consultation Service contacted all patients in order to assess risk factors for lung malignancy. Sixty-seven patients were excluded because they were unreachable, declined participation, or were actively followed by a pulmonologist or oncologist. A thoracic radiologist assessed the nodule and follow up recommendations in all remaining cases.
Results: A total of 215 cases were re-reviewed by thoracic radiologists. The thoracic radiologist disagreed with the initial nodule recommendations in 38% (82/215) of cases and agreed in 62% (133/215) of cases. All discordant cases resulted in a change in management by the thoracic radiologist with approximately one-third (33%, 27/82) decreasing imaging utilization and two-thirds (67%, 55/82) increasing imaging utilization. Nodules were deemed benign and follow up eliminated in 11% (9/82) of discordant cases.
Discussion: Our study illustrates that nodule review by thoracic radiologists results in a change in management in a large percentage of patients. Continued research is needed to determine whether subspecialty imaging review results in increased or more timely lung cancer detection.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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