Identifying the target: An audit of radiology reports for appropriate use of slice reference numbers

Abstract

Purpose or Objective As the capabilities of diagnostic imaging have advanced, higher levels of spatial resolution identify smaller lung abnormalities. Radiation oncologists are treating smaller and more ill defined targets. Many patients with lung cancer will have a background of chronic lung disease with associated abnormalities (e.g. small equivocal nodules) identified at the time of the RT planning scan. Guidance in the UK recommend references to image slices in the radiology reports to help the reader clearly identify abnormalities but this is not compulsory. Materials and Methods A retrospective review of the CT and PET reports of thirty patients (4 metastatic and 26 primary lung cancer) who received lung SABR to ascertain if the target lesion was clearly identified with a slice reference number. Results 24 patients (80%) had a slice reference number clearly identifying the target lesion. Out of theses 8 had detailed reports with slice reference numbers identifying the target lesion and benign abnormalities or areas requiring surveillance. 7 patients out of 30 had additional lesions visible on the RT planning scan which had previously been reported on diagnostic imaging and under surveillance. There was no slice reference number clearly distinguishing the lesion requiring treatment and that under surveillance for 3 of these patients. Conclusion Slice reference numbers were included in most but not all radiology reports. Where there are multiple lesions under surveillance slice reference numbers are beneficial in target lesion identification. Inclusion of slice reference numbers could be advocated as part of an error reduction strategy which would reduce the risk of the target being incorrectly delineated.