Learning objectives
To evaluate positron emission tomography - computed tomography (PET-CT) scans discussed at lung cancer multi disciplinary team (MDT) meeting in our institution and determine the following:
•Identification of the prevalent sites of extra thoracic incidental uptake and also how we identify and manage.
•Accurate documentation of extra-thoracic incidental findings in the MDT
•Recording of the recommended actions in MDT outcomes
•Evaluation of appropriate follow up for these patients
Background
The use of PET-CT in the management of cancer patients is on the increase due to its recommended use by the Department of Health and National Institute of Clinical Excellence (NICE).
As widespread clinical application increases,
identification of unexpected findings are not uncommon.
These incidental findings are often suspicious for a second primary malignancy.
There are more than 40,000 new cases of lung cancer in the UK each year and more than 35,000 people die from the condition; more than for breast cancer and colorectal...
Findings and procedure details
Method:
This was a retrospective review of all patients who had a PET-CT discussedat the lung cancer MDT meeting in Heartlands Hospital between1st January 2017 and 31st December 2017.
Incidental findings on PET-CT were identified from reviewing scan reports on the electronic patient records.
Using the records,
the following were analysed:
•Extra-thoracic Incidental findings
•Documentation of these in the MDT outcomes vs PET-CT report
•Actions taken by MDT following identification of extra-thoracic findings
•Outcomes of incidental finding investigation for each patient
Results:
A total of...
Conclusion
A significant number of patients with incidental non lung cancer related findings have been not appropriately followed up.
Along with organisinga mini-MDTto discuss those patients in details,
we also fedour resultsback to radiology department and thoracicMDT team.
Our study invokes the thought that whether there have been impact on other patients who were not in the audit period or discussed at different specialty MDTs.
In our cases,
the areas to improve on identified as:
•Clear documentation in PET-CT conclusions
•Findings to be flagged to MDT...
Personal information
1.
Dr Sadia Sultana,
Specialty Ragistrar,
Clinical Radiology,
University Hospitals Birmingham,
UK
Address: Birmingham Heartlands Hospital,
Bordersley Green East,
Birmingham,
United Kingdom B9 5SS
email:
[email protected]
2.
Dr Alison Stockbridge,
Specialty Ragistrar,
Respiratory Medicine,
University Hospitals Birmingham,
UK
Address: Birmingham Heartlands Hospital,
Bordersley Green East,
Birmingham,
United Kingdom B9 5SS
email:
[email protected]
3.
Dr Suhaila Mendes,
Specialty Ragistrar,
Respiratory Medicine,
University Hospitals Birmingham,
UK
Address: Birmingham Heartlands Hospital,
Bordersley Green East,
Birmingham,
United Kingdom B9 5SS
email:
[email protected]
4.
Dr Rifat Rashid,
Consultant,
Respiratory Medicine,...
References
National Institute of Clinical Excellence (NICE) ,Lung cancer: diagnosis and management,
Clinical guideline [CG121] Published date: April 2011
Br J Radiol. 2012 Jul;85(1015):e229-37.
doi: 10.1259/bjr/60606623
European Respiratory Journal 2018 52: Suppl.
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Ann R Coll Surg Engl.
2014 Apr; 96(3): 207–210