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Divergent Interpretations of Imaging After Stereotactic Body Radiation Therapy for Lung Cancer.

Publication ,  Journal Article
Ackerson, BG; Sperduto, W; D'Anna, R; Niedzwiecki, D; Christensen, J; Patel, P; Mullikin, TC; Kelsey, CR
Published in: Pract Radiat Oncol
2023

PURPOSE: Conflicting information from health care providers contributes to anxiety among cancer patients. The purpose of this study was to investigate discordant interpretations of follow-up imaging studies after lung stereotactic body radiation therapy (SBRT) between radiologists and radiation oncologists. METHODS AND MATERIALS: Patients treated with SBRT for stage I non-small cell lung cancer from 2007 to 2018 at Duke University Medical Center were included. Radiology interpretations of follow-up computed tomography (CT) chest or positron emission tomography (PET)/CT scans and the corresponding radiation oncology interpretations in follow-up notes from the medical record were assessed. Based on language used, interpretations were scored as concerning for progression (Progression), neutral differential listed (Neutral Differential), or favor stability/postradiation changes (Stable). Neutral Differential required that malignancy was specifically listed as a possibility in the differential. Encounters were categorized as discordant when either radiology or radiation oncology interpreted the surveillance imaging as Progression when the other interpreted the imaging study as Stable or Neutral Differential. The incidence of discordant interpretations was the primary endpoint of the study. RESULTS: From 2007 to 2018, 139 patients were treated with SBRT and had available follow-up CT or PET-CT imaging for the analysis. Median follow-up was 61 months and the median number of follow-up encounters per patient was 3. Of 534 encounters evaluated, 25 (4.7%) had overtly discordant interpretations of imaging studies. This most commonly arose when radiology felt the imaging study showed Progression but radiation oncology favored Stable or Neutral Differential (24/25, 96%). No patient or treatment variables were found to be significantly associated with discordant interpretations on univariate analysis including type of scan (CT 22/489, 4.5%; PET-CT 3/45, 7%; P = .46). CONCLUSIONS: Surveillance imaging after lung SBRT is often interpreted differently by radiologists and radiation oncologists, but overt discordance was relatively low at our institution. Providers should be aware of differences in interpretation patterns that may contribute to increased patient distress.

Duke Scholars

Published In

Pract Radiat Oncol

DOI

EISSN

1879-8519

Publication Date

2023

Volume

13

Issue

2

Start / End Page

e126 / e133

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Radiosurgery
  • Positron-Emission Tomography
  • Positron Emission Tomography Computed Tomography
  • Lung Neoplasms
  • Humans
  • Carcinoma, Non-Small-Cell Lung
  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Ackerson, B. G., Sperduto, W., D’Anna, R., Niedzwiecki, D., Christensen, J., Patel, P., … Kelsey, C. R. (2023). Divergent Interpretations of Imaging After Stereotactic Body Radiation Therapy for Lung Cancer. Pract Radiat Oncol, 13(2), e126–e133. https://doi.org/10.1016/j.prro.2022.09.006
Ackerson, Bradley G., William Sperduto, Rachel D’Anna, Donna Niedzwiecki, Jared Christensen, Pranalee Patel, Trey C. Mullikin, and Chris R. Kelsey. “Divergent Interpretations of Imaging After Stereotactic Body Radiation Therapy for Lung Cancer.Pract Radiat Oncol 13, no. 2 (2023): e126–33. https://doi.org/10.1016/j.prro.2022.09.006.
Ackerson BG, Sperduto W, D’Anna R, Niedzwiecki D, Christensen J, Patel P, et al. Divergent Interpretations of Imaging After Stereotactic Body Radiation Therapy for Lung Cancer. Pract Radiat Oncol. 2023;13(2):e126–33.
Ackerson, Bradley G., et al. “Divergent Interpretations of Imaging After Stereotactic Body Radiation Therapy for Lung Cancer.Pract Radiat Oncol, vol. 13, no. 2, 2023, pp. e126–33. Pubmed, doi:10.1016/j.prro.2022.09.006.
Ackerson BG, Sperduto W, D’Anna R, Niedzwiecki D, Christensen J, Patel P, Mullikin TC, Kelsey CR. Divergent Interpretations of Imaging After Stereotactic Body Radiation Therapy for Lung Cancer. Pract Radiat Oncol. 2023;13(2):e126–e133.
Journal cover image

Published In

Pract Radiat Oncol

DOI

EISSN

1879-8519

Publication Date

2023

Volume

13

Issue

2

Start / End Page

e126 / e133

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Radiosurgery
  • Positron-Emission Tomography
  • Positron Emission Tomography Computed Tomography
  • Lung Neoplasms
  • Humans
  • Carcinoma, Non-Small-Cell Lung
  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences