Dedicated discussions between diagnostic radiologists and radiation oncologists provide significant value when treating thoracic oncology patients, according to a new study published in Current Problems in Diagnostic Radiology.
“Investigators have reviewed the specific role of imaging in thoracic oncology tumor board patients in published case review series, however there is a relative lack of data in this area,” wrote lead author Kimberly G. Kallianos, MD, department of radiology and biomedical imaging at the University of California, San Francisco, and colleagues. “Specifically, it is unclear how much value discussion with a radiologist in the tumor board setting provides beyond the written report, and it is also unclear if additional smaller group meetings can add value beyond a larger group tumor board discussion.”
The authors explored data from 122 cases presented at multidisciplinary thoracic tumor boards (TTB) between June and August 2017 at a single institution. A subset of those cases (45) were also presented at diagnostic radiology/radiation oncology rounds (DR/RORs). Diagnostic radiologists presented in both settings, and the DR/RORs occurred when cases were “specifically identified by radiation oncology physicians as cases which needed further review.”
Overall, discussing imaging with the radiologist changed radiation oncology management in 31.1% of all cases presented at a TTB and 68.9% of all cases presented at a DR/ROR. The change was related to the timing of the patient’s radiation therapy for 31.1% of TTB cases and 46.7% of DR/ROR cases.
In addition, the authors observed, the level of confidence in radiation oncology management increased after the diagnostic radiologist’s involvement in 95.6% of the cases presented at a DR/ROR. The two instances when confidence did not increase were one where it stayed the same and another when it decreased “due to the imaging discussion introducing uncertainty as to whether a new finding represented a metastasis.”
“Greater than half of the discussions between diagnostic radiologists and radiation oncologists resulted in at least a moderate change in radiation oncology management, showing that the impact of imaging discussion rather than simply reading a formal report is not trivial,” the authors wrote. “Another unique benefit of the DR/ROR was the opportunity to improve the confidence level of radiation oncology physicians in their management, independent of whether or not the management was altered.”
The research did have limitations, the researchers wrote, including the fact that changes in patient management were assessed at a single point in time as opposed to being measured over “multiple time points.” In addition, patient outcomes were not tracked, so it could not be confirmed if each change resulted in a positive outcome.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.