LDCT scan reporting and review
cancers, incidental abnormalities, Lung Cancer
CANCERS, TRACTION BRONCHIECTASIS, LUNG CANCER
LDCT scans for YLST are reported by a team of eight consultant radiologists with a subspecialty interest in thoracic imaging. Scans are reported using Veolity (MeVis AG), a bespoke software package for Lung Cancer screening including automated volumetry and computer-aided detection. In addition to protocolised reporting of nodules and possible cancers, free-text comments allow reporting of other incidental abnormalities with the option of a flag for clinically significant findings requiring clinical review. All scans with such a flag are reviewed at a screening review meeting (SRM) attended by a consultant thoracic radiologist and a consultant respiratory physician. At the SRM, electronic healthcare records and previous imaging performed outside of YLST are available for review. The radiologists who attend the SRMs also regularly contribute to ILD multidisciplinary team (MDT) meetings. Scans without a clinical flag are signed off by a respiratory physician, with the option of listing for SRM if further discussion is thought necessary.The YLST reporting radiologists were asked to mention ILA in their clinical report in all cases, and to mark the scan report as having a significant incidental finding if there were clinically significant ILA defined as evidence of traction bronchiectasis or >10% reticulation. Some cases that were not flagged but had comments regarding ILA were also discussed at the discretion of YLST physicians. Following discussion at an SRM, if a clinically significant previously undiagnosed ILD was thought possible, a telephone clinic appointment with a YLST clinician was arranged. At this review, further relevant history was obtained, participants were advised of the scan findings and onward referral to the regional ILD service was organised. A letter outlining the LDCT findings and any further management was sent to both the patient and general practitioner.