Centralized Lung Nodule Management at A VeteransHospital Using A Multidisciplinary Lung NoduleEValuation Team(LNET)

作     者：William R.WRIGHTSON Umar GAUHAR Fred HENDLER Teresa JOINER Jennifer PENDLETON William R.WRIGHTSON;Umar GAUHAR;Fred HENDLER;Teresa JOINER;Jennifer PENDLETON

作者机构：Robley Rex Veterans Affairs (VA)Medical CenterLouisvilleKentuckyUSA 

出 版 物：《中国肺癌杂志》 (Chinese Journal of Lung Cancer)

年 卷 期：2018年第21卷第11期

页      面：828-832页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Lung nodule Cancer Mulfidiscliplinary 

摘      要：Introduction: Lung nodules are frequently identified on imaging studies and can represent early lung cancers. We instituted the Lung Nodule Evaluation Team(LNET) to optimize management of these nodules by a lung specialist physician. All lung nodules identified by a radiologist prompted a direct consultation to this service. We report our initial experience with this process. Methods: This is a retrospective review of patients with lung nodules at a single institution from 2008 to 2015. Since October 2014, lung nodules 3 mm identified on computed tomography(CT) scanning of the chest generate an automatic consult to LNET from the radiology service. Demographic, nodule and follow up data was entered into a surveillance database and ***: There were 1,873 patients identified in the database. Of these, 900 patients were undergoing active surveillance. Consults increased from 5.5 to 93 per month after the start of the new consult program. Lung nodules were identified on 64% of chest CT scans. Prior to the direct radiology consult the average size of a nodule was 1.7 cm and 0.7 cm after. The overall time from initial nodule imaging to initiating a management plan by a thoracic specialist physician was 3.7 days. Conclusion: Assessment of lung nodules by a specialist physician is important to ensure appropriate long term management and optimize utilization of diagnostic interventions. A direct radiology consult to a specialized team of chest physicians decreased the time in initiating a management plan, identified smaller nodules and may lead to a more judicious use of health care resources in the management of lung nodules.