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IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology Pub Date : 2025-03-01 DOI:10.1016/j.jacr.2024.12.003

Aparna Singh MD, Mark M. Hammer MD, Suzanne C. Byrne MD

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引用次数: 0

摘要

方法我们对 2015 年 1 月至 2023 年 8 月期间医疗保健系统内的所有 LCS CT 检查进行了回顾性分析。我们纳入了因肾上腺局灶性病变而报告的带有 Lung-RADS "S" 修饰符的 CT。我们记录了是否建议进行后续成像和生化检测，以及是否进行了这些检测。我们对报告中的随访建议是否符合 ACR 建议进行了评估。根据 ACR 建议，191 例患者中有 36 例（19%）需要随访，但 36 例中只有 23 例（64%）收到了随访建议。在这 191 人中，有 155 人（81%）不需要根据 ACR 进行随访，而这 155 人中有 25 人（16%）收到了随访建议。在被建议进行随访的患者中，48 人中有 34 人（71%）接受了专门的随访，48 人中有 9 人（19%）因其他原因接受了成像随访，48 人中有 5 人（10%）没有接受任何随访。在未被建议随访的患者中，143 人中有 21 人（15%）接受了专门的随访，143 人中有 101 人（71%）因其他原因接受了成像随访，143 人中有 21 人（15%）未接受任何随访。没有诊断出恶性病变。根据 ACR 建议，191 例患者中有 183 例（96%）本应接受生化检查，但只有 4 例患者（2%）被建议接受生化检查。尽管生化检测是 ACR 算法的一部分，但几乎没有生化检测建议。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Incidentally Detected Adrenal Nodules on Lung Cancer Screening CT

Objective

To assess adherence to ACR recommendations for managing incidental adrenal lesions detected on lung cancer screening (LCS) CT examinations.

Methods

We performed a retrospective analysis of all LCS CT examinations within our health care system from January 2015 to August 2023. We included CTs that were reported with Lung-RADS “S” modifier for a focal adrenal lesion. We recorded whether follow-up imaging and biochemical testing were recommended and whether they were performed. Follow-up recommendations in reports were assessed for adherence to ACR recommendations.

Results

During the study period, 191 patients had a focal adrenal nodule reported. Per ACR recommendations, 36 of 191 (19%) warranted follow-up, but only 23 of 36 (64%) of these received follow-up recommendations. Of those 191, 155 (81%) did not require follow-up per ACR, and 25 of those 155 (16%) received follow-up recommendations. Of those who were advised follow-up, 34 of 48 (71%) received dedicated follow-up, 9 of 48 (19%) received follow-up imaging for another reason, and 5 of 48 (10%) did not receive any follow-up. Among those in whom follow-up was not recommended, 21 of 143 (15%) received dedicated follow-up, 101 of 143 (71%) received follow-up imaging for another reason, and 21 of 143 (15%) did not receive any follow-up. No malignant lesions were diagnosed. Per ACR recommendations, 183 of 191 (96%) of patients should have received biochemical testing; however, it was recommended in only 4 patients (2%).

Discussion

There was suboptimal adherence to ACR recommendations for managing incidental adrenal lesions on LCS CTs, with both unnecessary and missing follow-up recommendations. Recommendations for biochemical testing were nearly nonexistent, despite being part of the ACR algorithm.

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来源期刊

Journal of the American College of Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

6.30

自引率

8.90%

发文量

312

审稿时长

34 days

期刊介绍： The official journal of the American College of Radiology, JACR informs its readers of timely, pertinent, and important topics affecting the practice of diagnostic radiologists, interventional radiologists, medical physicists, and radiation oncologists. In so doing, JACR improves their practices and helps optimize their role in the health care system. By providing a forum for informative, well-written articles on health policy, clinical practice, practice management, data science, and education, JACR engages readers in a dialogue that ultimately benefits patient care.