Impact of PET-CT reporting delays and incidental extra-thoracic findings in lung cancer diagnosis
Introduction: PET-CT is pivotal in lung cancer diagnosis and staging, uncovering thoracic and extra-thoracic findings that guide multidisciplinary team (MDT) decisions. Timely PET-CT reporting (<3 days) and adherence to Getting It Right First Time (GIRFT)’s 5-day turnaround time (TAT) are crucial...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-07-01
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| Series: | Clinical Medicine |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1470211825001319 |
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| Summary: | Introduction: PET-CT is pivotal in lung cancer diagnosis and staging, uncovering thoracic and extra-thoracic findings that guide multidisciplinary team (MDT) decisions. Timely PET-CT reporting (<3 days) and adherence to Getting It Right First Time (GIRFT)’s 5-day turnaround time (TAT) are crucial for meeting NHS England’s Faster Diagnosis Standard, ensuring streamlined pathways.1,2 Incidental extra-thoracic findings often reveal critical pathologies, including metastases, with major implications. This study investigated PET-CT reporting, PET-CT to MDT TATs, and predictors of extra-thoracic malignancies to optimise patient care strategies. Methods: A retrospective analysis of 124 patients referred to the local Lung MDT after PET-CT scans (August–October 2024) was conducted. Two patients (missing data) were excluded from PET-CT reporting TAT analysis, and eight (pre-reviewed cases) from PET-CT to MDT TAT analysis. Incidence and predictors of unexpected extra-thoracic findings were analysed for all patients using logistic regression. Results: In our cohort, the average age was 69.3 years; 52.4% (n=65) were women, 83.9% (n=104) smokers, and 22.6% (n=28) had had cancer within the previous 5 years. PET-CT reporting TATs: 15.6% within 24 h, 62.3% within 72 h. PET-CT reports delayed MDT discussions in 10.3% (n=12) of cases, with significantly longer PET-CT reporting and PET-CT to MDT TATs compared with non-delayed cases (mean 101.8 h vs 65.05 h; 10.58 days vs 7.38 days, p<0.001). Incidental extra-thoracic findings were identified in 54.8% (n=68), most frequently in gastrointestinal sites (21.7%, n=27).Further investigations were required in 29.8% (n=37), confirming malignancies in 15.3% (n=19). Logistic regression identified male sex (OR=53.557, p=0.025) and a history of malignancy within 5 years (OR=0.021, p=0.013) as significant predictors of extra-thoracic malignancies (Table 1). Conclusions: High rates of incidental extra-thoracic findings, including malignancies, and failure to meet GIRFT’s recommended turnaround times highlight the need for strategies to optimise diagnostic pathways and support the achievement of NHS Faster Diagnosis goals in lung cancer. |
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| ISSN: | 1470-2118 |