November 7, 2019 --
CT lung screening scans occasionally produce false-positive results that can lead to unnecessary downstream testing. To address this issue, researchers from the Banner Health Network have proposed setting up panels to review positive screening exams before making final recommendations.
The group, led by Dr. Michael Morris of Banner - University Medical Center Phoenix, investigated the advantages of having a multidisciplinary panel -- consisting of radiologists, interventional pulmonologists, and thoracic surgeons -- review all positive CT screening scans within its health network based on the Lung Imaging Reporting and Data System (Lung-RADS) reporting tool.
Among 205 screening exams initially determined to be positive in 2017 and 2018, the panel changed the classification of roughly 16% of the exams -- recategorizing the exams from Lung-RADS 3 to Lung-RADS 4 or vice versa.
The most common reason for changing the Lung-RADS score was failing to meet the Lung-RADS sizing criteria adequately during the initial review. Though less common, the panel also changed the Lung-RADS score for several exams after concluding that certain nodules were not benign but suspicious, and vice versa.
"Multidisciplinary review had a trend toward impacting lung cancer diagnosis, with Lung-RADS upcoding leading to early detection of lung cancer in two patients and downcoding resulting in a potential delay in cancer diagnosis in one patient," Morris told AuntMinnie.com.