Making sure suspicious imaging findings are followed up appropriately is a key element in providing quality patient care. But a new study found that some suspicious findings aren’t being adequately tracked, especially when it comes to lung nodules.
Lung nodules are commonly detected on chest CT exams, and are often found incidentally, when patients are being examined for other reasons.
- While most smaller nodules don’t represent a threat to patients, it’s important to work up the ones that could be clinically significant.
In the new paper, Japanese researchers studied 10.5k initial chest CT reports at their institution from 2020 to 2023.
- They developed a natural language processing algorithm that analyzed free-text reports to see which ones recommended follow-up.
They determined that 1.5k reports (14%) recommended additional imaging with exams like chest CT or PET/CT; they then calculated whether these follow-up exams were conducted within 400 days of the initial exam. Further analysis indicated …
- For 36% of exams (543) researchers could not confirm that follow-up imaging had taken place.
- In a random sample of 42 of these patients, 40.5% (17) were not followed up appropriately.
- For these cases, either no imaging was documented or no reason was given for the lack of follow-up.
The researchers clarified that they found no evidence of false negatives (missed cancers), as that wasn’t a goal of their study.
The Takeaway
The new findings indicate both the challenge and opportunity of follow-up management. While radiology must do better in tracking patients with suspicious findings, the study shows that software-based solutions could help, especially those that are automated to scan radiology reports and alert radiologists to cases that need their attention.
