1 Kardiovaskulær og Renal Forskning, Department of Molecular Medicine, Det Sundhedsvidenskabelige Fakultet, SDU2 Lung Medicine, Department of Clinical Research, Det Sundhedsvidenskabelige Fakultet, SDU3 Kardiovaskulær og Renal Forskning, Department of Molecular Medicine, Det Sundhedsvidenskabelige Fakultet, SDU4 Lung Medicine, Department of Clinical Research, Det Sundhedsvidenskabelige Fakultet, SDU
Adherence to follow-up CT scans in patients with small pulmonary nodules, a retrospective study The Danish National guidelines have since 2008 suggested serial follow-up CT scans at 3, 6, 12, and 24 months for nodules between 5 and 10 mm and at 12 and 24 months for nodules less than 5 mm in accordance with Ellis et al. Clin Radiol 2001, 56, 691-9. As a part of our quality assurance efforts, we wanted to investigate how this follow-up proceeded - before and after the publication of the National guidelines. At our diagnostic unit we recorded 2961 cases referred for a suspected thoracic malignancy in the four year period 2006-2009. In 72 cases, 19 in 2006-2007 and 51 in 2008-2009, one or more small nodules, with diameter ≤ 10 mm, were detected on CT in patients with no known recent malignant disease. For these patients follow-up was suggested, either with CT or PET-CT. One of the 70 patients from 2008 was referred to another hospital and we have insufficient data on the follow-up. Another patient – also from 2008 -never came to the suggested first follow-up. Fifty eight patients have completed the first follow-up, while 10 are waiting for the first scheduled control CT. In twelve of the 19 patients (63 %) registered in 2006-2007 the follow-up ended after the first 3 month CT, compared to 17 of the 49 patients (33 %) in 2008-2009 (p = 0.064, Fisher’s exact test). In 28 (55 %) of all the cases registered in 2008-2009 the follow-up program was completed or on-going as planned as of February 2010. Our conclusion is that management of the follow-up of small nodules did improve in 2008-2009, but adherence to the guidelines was still limited. We will now implement a prospective program for monitoring the adherence to the follow-up CTs.