J R J Willems, M J Lahaye, P Snaebjornsson, S Marchetti, M A Vollebergh, L W van Golen, W V Vogel, Z J Cheung, S Rostami, Z Bodalal, R G H Beets-Tan, D M J Lambregts
{"title":"Optimising Diagnostic Pathways through digital Multidisciplinary Team management of Patients with Cancer of Unknown Primary: a Retrospective Analysis.","authors":"J R J Willems, M J Lahaye, P Snaebjornsson, S Marchetti, M A Vollebergh, L W van Golen, W V Vogel, Z J Cheung, S Rostami, Z Bodalal, R G H Beets-Tan, D M J Lambregts","doi":"10.1093/bjr/tqaf228","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Diagnostic pathways for cancer of unknown primary (CUP) are often underdeveloped. At our tertiary referral centre for CUP, we recently introduced a new diagnostic workflow that includes digital discussion of CUP patients by a dedicated multidisciplinary team (MDT), centralised second opinion reviews, and an MDT-guided approach to further diagnostic steps. This study retrospectively assesses the outcomes of this optimised workflow on efficiency, diagnostic yield, and healthcare professional satisfaction.</p><p><strong>Methods: </strong>We retrospectively compared outcomes for 39 patients from period A(May 2021-April 2022) to 41 patients from period B(Dec 2022-Nov 2023) following workflow optimisation. Outcomes included time-to-diagnosis, diagnostic yield, impact of second opinion imaging reviews, and satisfaction levels among involved MDT members.</p><p><strong>Results: </strong>After workflow implementation, median time to diagnosis/treatment decreased from 36 to 28 days(p = 0.07). Second opinion imaging reviews led to the detection of new tumour lesions in 10% of cases. A primary tumour diagnosis was established 49% patients from period A versus 61% in period B(p = 0.37). Satisfaction among MDT members notably improved, especially regarding interdisciplinary communication and workflow efficiency.</p><p><strong>Conclusion: </strong>Our optimised CUP workflow with digital MDT-discussions and routine second opinion reviews of imaging and pathology data, improved diagnostic efficiency and satisfaction among physicians. These results highlight the value of a multidisciplinary, patient-centred approach focused on effective patient management in CUP.</p><p><strong>Advances in knowledge: </strong>Integrating digital MDT discussions and centralized second-opinion reviews in CUP care improves diagnostic efficiency and may enhance primary tumour detection rates. Radiologists and other diagnosticians play a key role in this multidisciplinary approach.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/bjr/tqaf228","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Diagnostic pathways for cancer of unknown primary (CUP) are often underdeveloped. At our tertiary referral centre for CUP, we recently introduced a new diagnostic workflow that includes digital discussion of CUP patients by a dedicated multidisciplinary team (MDT), centralised second opinion reviews, and an MDT-guided approach to further diagnostic steps. This study retrospectively assesses the outcomes of this optimised workflow on efficiency, diagnostic yield, and healthcare professional satisfaction.
Methods: We retrospectively compared outcomes for 39 patients from period A(May 2021-April 2022) to 41 patients from period B(Dec 2022-Nov 2023) following workflow optimisation. Outcomes included time-to-diagnosis, diagnostic yield, impact of second opinion imaging reviews, and satisfaction levels among involved MDT members.
Results: After workflow implementation, median time to diagnosis/treatment decreased from 36 to 28 days(p = 0.07). Second opinion imaging reviews led to the detection of new tumour lesions in 10% of cases. A primary tumour diagnosis was established 49% patients from period A versus 61% in period B(p = 0.37). Satisfaction among MDT members notably improved, especially regarding interdisciplinary communication and workflow efficiency.
Conclusion: Our optimised CUP workflow with digital MDT-discussions and routine second opinion reviews of imaging and pathology data, improved diagnostic efficiency and satisfaction among physicians. These results highlight the value of a multidisciplinary, patient-centred approach focused on effective patient management in CUP.
Advances in knowledge: Integrating digital MDT discussions and centralized second-opinion reviews in CUP care improves diagnostic efficiency and may enhance primary tumour detection rates. Radiologists and other diagnosticians play a key role in this multidisciplinary approach.
期刊介绍：
BJR is the international research journal of the British Institute of Radiology and is the oldest scientific journal in the field of radiology and related sciences.
Dating back to 1896, BJR’s history is radiology’s history, and the journal has featured some landmark papers such as the first description of Computed Tomography "Computerized transverse axial tomography" by Godfrey Hounsfield in 1973. A valuable historical resource, the complete BJR archive has been digitized from 1896.
Quick Facts:
- 2015 Impact Factor – 1.840
- Receipt to first decision – average of 6 weeks
- Acceptance to online publication – average of 3 weeks
- ISSN: 0007-1285
- eISSN: 1748-880X
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