Nodule net: A centralized prospective lung nodule tracking and safety-net program

Area of Science:

• Pulmonology
• Radiology
• Oncology

Background:

• Inadequate follow-up of lung nodules delays diagnosis and can lead to advanced lung cancer.
• A multidisciplinary lung nodule management program, Nodule Net, was established in 2015 to enhance timely follow-up.
• This study evaluates the effectiveness of the Nodule Net program.

Purpose of the Study:

• To assess the impact of the Nodule Net program on the rate of timely follow-up imaging for suspicious lung nodules.
• To compare follow-up rates in patients managed by Nodule Net versus standard care.

Main Methods:

• Reviewed 2398 chest CT reports for lung nodules and collected data on demographics, nodule characteristics, and follow-up recommendations.
• Applied Fleischner Society guidelines for reports lacking structured recommendations.
• Compared follow-up imaging rates with historical data.

Main Results:

• Lung nodules were identified in 57% of scans.
• For patients with follow-up recommendations, Nodule Net was notified in 83% of cases.
• Follow-up completion was 78% for Nodule Net patients versus 52% for non-Nodule Net patients (RR 1.49, p<0.05).
• Lung malignancy was diagnosed in 4% of patients whose follow-up was prompted by Nodule Net outreach.

Conclusions:

• Lung nodule management is complex, but tracking programs improve follow-up completion.
• The Nodule Net program significantly increased recommended follow-up imaging compared to usual care.
• Automated systems for tracking incidental findings may further reduce follow-up barriers.