Centralized Lung Nodule Management at A Veterans Hospital Using A Multidisciplinary Lung Nodule Evaluation Team...

Area of Science:

• Pulmonology
• Radiology
• Oncology

Background:

• Lung nodules are common findings in imaging and can indicate early lung cancer.
• A Lung Nodule Evaluation Team (LNET) was established to improve specialist management of lung nodules.
• The LNET process involves direct radiologist consultation for all identified lung nodules.

Purpose of the Study:

• To evaluate the initial experience and impact of the Lung Nodule Evaluation Team (LNET).
• To assess the effectiveness of a specialist physician-led approach to lung nodule management.
• To determine if the LNET process optimizes diagnostic interventions and resource utilization.

Main Methods:

• Retrospective review of patients with lung nodules from 2008 to 2015.
• Implementation of an automatic consult system for lung nodules >3 mm on CT scans since October 2014.
• Data collection on demographics, nodules, and follow-up, summarized in a surveillance database.

Main Results:

• 1,873 patients were identified, with 900 under active surveillance.
• Monthly consults increased significantly from 5.5 to 93 after the LNET program initiation.
• Average nodule size decreased from 1.7 cm to 0.7 cm post-LNET implementation, with management plans initiated in 3.7 days.

Conclusions:

• Specialist physician assessment is crucial for lung nodule management and optimizing interventions.
• The direct radiology consult to LNET expedited management plan initiation.
• The LNET approach identified smaller nodules and potentially improved healthcare resource utilization for lung nodules.