Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Radiologist recommendations for chest CT have high clinical yield

22.12.2014

A substantial percentage of patients who receive radiologist recommendations for chest computed tomography (CT) to evaluate abnormal findings on outpatient chest X-rays have clinically relevant findings, including cancer, according to a new study published online in the journal Radiology.

Researchers said the findings show that radiologist recommendations for additional imaging (RAIs) after chest X-rays represent valuable contributions to patient care.

RAIs, which have grown 200 percent since 1995, have attracted scrutiny in recent years as healthcare moves from volume-driven to value-based payment models. The scrutiny makes it increasingly important for the radiology community to validate the clinical impact of its work, said study author Tarik K. Alkasab, M.D., Ph.D., from Massachusetts General Hospital and Harvard Medical School in Boston.

"There has been a great deal of research on how radiologists recommend an imaging exam, but little on what comes out of the exams that they recommend," Dr. Alkasab said. "Prior studies were very broad, so in our study we tried to focus on a specific clinical scenario."

Dr. Alkasab and colleagues looked at chest X-rays, one of the most common outpatient diagnostic imaging studies performed in the United States. As many as half of all RAIs arising from thoracic diagnostic exams are prompted by chest X-rays.

The researchers combed through more than 29,000 reports of outpatient chest X-rays performed at a large academic center over one year to identify studies that included a recommendation for a chest CT. They found that radiologists interpreting outpatient chest X-rays made recommendations for CT in 4.5 percent of cases--a result in line with existing research. Increasing patient age and positive smoking history were associated with an increased likelihood of a chest CT recommendation.

When the researchers looked at the chest CTs obtained within one year of the index chest X-ray, they found that 41.4 percent detected a corresponding abnormality requiring treatment or further diagnostic workup. One in every 13 yielded a corresponding abnormality representing a newly-diagnosed, biopsy-proven malignancy.

"In this era of concern about radiation dose risk, these findings suggest that the extremely low predicted risk of radiation-induced cancer associated with a chest CT is orders of magnitude less than the potential clinical benefits," said study co-author H. Benjamin Harvey, M.D., J.D., from Massachusetts General Hospital and Harvard Medical School. "If ordering physicians see a recommendation for chest CT, they need to ensure that the patient gets the recommended imaging."

More than one-third of patients in the study group who were recommended for follow-up chest CT did not receive the exam within one year--an oversight that could result in missed or delayed diagnoses, the researchers said.

"More research is needed to understand the possible reasons for the less-than-optimal adherence to RAIs after chest X-ray," Dr. Harvey said. "One thing we're looking at is how the recommendation language affects recommendation adherence."

The researchers hope that their study helps improve awareness of the importance of follow-up CT.

"These results show that radiologists should be confident their recommendations are adding value and protecting patients," Dr. Alkasab said.

"Diagnostic Yield of Recommendations for Chest CT Examination Prompted by Outpatient Chest Radiographic Findings." Collaborating with Drs. Alkasab and Harvey were Matthew D. Gilman, M.D., Carol C. Wu, M.D., Matthew S. Cushing, M.D., Elkan F. Halpern, Ph.D., Jing Zhao, Ph.D., Pari V. Pandharipande, M.D., MPH, and Jo-Anne O. Shepard, M.D.

Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc.

RSNA is an association of more than 54,000 radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)

For patient-friendly information on chest X-ray and chest CT, visit RadiologyInfo.org.

Media Contact

Linda Brooks
lbrooks@rsna.org
630-590-7762

@rsna

http://www.rsna.org

Linda Brooks | EurekAlert!

Further reports about: CT Chest RSNA Radiological Society Radiologist X-ray X-rays chest X-rays

More articles from Medical Engineering:

nachricht Virtual Reality in Medicine: New Opportunities for Diagnostics and Surgical Planning
07.12.2016 | Universität Basel

nachricht 3-D printed kidney phantoms aid nuclear medicine dosing calibration
06.12.2016 | Society of Nuclear Medicine

All articles from Medical Engineering >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Electron highway inside crystal

Physicists of the University of Würzburg have made an astonishing discovery in a specific type of topological insulators. The effect is due to the structure of the materials used. The researchers have now published their work in the journal Science.

Topological insulators are currently the hot topic in physics according to the newspaper Neue Zürcher Zeitung. Only a few weeks ago, their importance was...

Im Focus: Significantly more productivity in USP lasers

In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.

Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...

Im Focus: Shape matters when light meets atom

Mapping the interaction of a single atom with a single photon may inform design of quantum devices

Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

Researchers identify potentially druggable mutant p53 proteins that promote cancer growth

09.12.2016 | Life Sciences

Scientists produce a new roadmap for guiding development & conservation in the Amazon

09.12.2016 | Ecology, The Environment and Conservation

Satellites, airport visibility readings shed light on troops' exposure to air pollution

09.12.2016 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>