AuntMinnie.com X-Ray Radiology Insider

It's not a "miss" if the radiologist documents an unsuspected radiographic finding on a chest x-ray, but who's to blame if there's no follow-up?

Dear X-ray Insider,

It's not a "miss" if the radiologist documents an unsuspected radiographic finding on a chest x-ray, but who's to blame if there's no follow-up?

After missing the opportunity to diagnose one patient's lung cancer before it became unresectable, the Veterans Affairs Medical Center in Portland, OR, decided that follow-up was an institutional responsibility.

The center instituted a procedure for routinely following all unsuspected radiographic findings, and has since caught many early-stage cancers, as described in this month's Insider Exclusive.

"We were actually a little bit surprised how much early lung cancer we picked up in this pathway," said pulmonary specialist Dr. Mark E. Deffebach. "One of the messages is that those (unsuspected) findings do pick up a fair amount of cancer, at least in our patient population."

While a few observers consider the Portland VA's follow-up to be inappropriate self-referral, the potential benefits seem obvious to others.

"Whether we're picking (cancers) up at a time where we really have things turn out differently or not for the patient is uncertain," Deffebach said. "But it's a service that the radiologists appreciate, the primary care docs appreciate, and we feel brings an appropriate level of care quickly to the problem."

You'll find this and other recent stories related to x-ray imaging in AuntMinnie's X-Ray Digital Community.

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