Korean J Radiol.  2017 Feb;18(1):107-112. 10.3348/kjr.2017.18.1.107.

Evidence-Based Cancer Imaging

• Shinagare
• Khorasani

• KMID: 2468126
• DOI: http://doi.org/10.3348/kjr.2017.18.1.107

Abstract

With the advances in the field of oncology, imaging is increasingly used in the follow-up of cancer patients, leading to concerns about over-utilization. Therefore, it has become imperative to make imaging more evidence-based, efficient, cost-effective and equitable. This review explores the strategies and tools to make diagnostic imaging more evidence-based, mainly in the context of follow-up of cancer patients.

Keyword

Evidence-based imaging; Cancer imaging; Computerized physician order entry; Clinical decision support

MeSH Terms

Decision Support Systems, Clinical
Evidence-Based Medicine/methods
Humans
Incidental Findings
Neoplasm Metastasis
Neoplasms/*diagnostic imaging

Reference

1. Berland LL, Silverman SG, Gore RM, Mayo-Smith WW, Megibow AJ, Yee J, et al. Managing incidental findings on abdominal CT: white paper of the ACR incidental findings committee. J Am Coll Radiol. 2010; 7:754–773.

2. Casarella WJ. A patient's viewpoint on a current controversy. Radiology. 2002; 224:927.

3. Makarov DV, Hu EY, Walter D, Braithwaite RS, Sherman S, Gold HT, et al. Appropriateness of prostate cancer imaging among veterans in a delivery system without incentives for overutilization. Health Serv Res. 2016; 51:1021–1051.

4. Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Web site. Accessed June 1, 2016. http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf.

5. Pao W, Miller V, Zakowski M, Doherty J, Politi K, Sarkaria I, et al. EGF receptor gene mutations are common in lung cancers from “never smokers” and are associated with sensitivity of tumors to gefitinib and erlotinib. Proc Natl Acad Sci U S A. 2004; 101:13306–13311.

6. Kwak EL, Bang YJ, Camidge DR, Shaw AT, Solomon B, Maki RG, et al. Anaplastic lymphoma kinase inhibition in non-small-cell lung cancer. N Engl J Med. 2010; 363:1693–1703.

7. Motzer RJ, Bukowski RM. Targeted therapy for metastatic renal cell carcinoma. J Clin Oncol. 2006; 24:5601–5608.

8. Hendee WR, Becker GJ, Borgstede JP, Bosma J, Casarella WJ, Erickson BA, et al. Addressing overutilization in medical imaging. Radiology. 2010; 257:240–245.

9. Wood BP. What's the evidence? Radiology. 1999; 213:635–637.

10. National Comprehensive Cancer Network. Evidence-Based Cancer Guidelines, Oncology Drug Compendium, Oncology Continuing Medical Education. Web site. Accessed June 15, 2016. https://www.nccn.org/.

11. Chambers DA, Feero WG, Khoury MJ. Convergence of implementation science, precision medicine, and the learning health care system: a new model for biomedical research. JAMA. 2016; 315:1941–1942.

12. Furtado CD, Aguirre DA, Sirlin CB, Dang D, Stamato SK, Lee P, et al. Whole-body CT screening: spectrum of findings and recommendations in 1192 patients. Radiology. 2005; 237:385–394.

13. Sistrom CL, Dreyer KJ, Dang PP, Weilburg JB, Boland GW, Rosenthal DI, et al. Recommendations for additional imaging in radiology reports: multifactorial analysis of 5.9 million examinations. Radiology. 2009; 253:453–461.

14. Patel MD, Ascher SM, Paspulati RM, Shanbhogue AK, Siegelman ES, Stein MW, et al. Managing incidental findings on abdominal and pelvic CT and MRI, part 1: white paper of the ACR Incidental Findings Committee II on adnexal findings. J Am Coll Radiol. 2013; 10:675–681.

15. Khosa F, Krinsky G, Macari M, Yucel EK, Berland LL. Managing incidental findings on abdominal and pelvic CT and MRI, Part 2: white paper of the ACR Incidental Findings Committee II on vascular findings. J Am Coll Radiol. 2013; 10:789–794.

16. Heller MT, Harisinghani M, Neitlich JD, Yeghiayan P, Berland LL. Managing incidental findings on abdominal and pelvic CT and MRI, part 3: white paper of the ACR Incidental Findings Committee II on splenic and nodal findings. J Am Coll Radiol. 2013; 10:833–839.

17. Sebastian S, Araujo C, Neitlich JD, Berland LL. Managing incidental findings on abdominal and pelvic CT and MRI, Part 4: white paper of the ACR Incidental Findings Committee II on gallbladder and biliary findings. J Am Coll Radiol. 2013; 10:953–956.

18. Castillo G, Alcázar JL, Jurado M. Natural history of sonographically detected simple unilocular adnexal cysts in asymptomatic postmenopausal women. Gynecol Oncol. 2004; 92:965–969.

19. Modesitt SC, Pavlik EJ, Ueland FR, DePriest PD, Kryscio RJ, van Nagell JR Jr. Risk of malignancy in unilocular ovarian cystic tumors less than 10 centimeters in diameter. Obstet Gynecol. 2003; 102:594–599.

20. Pickhardt PJ, Hanson ME. Incidental adnexal masses detected at low-dose unenhanced CT in asymptomatic women age 50 and older: implications for clinical management and ovarian cancer screening. Radiology. 2010; 257:144–150.

21. Levine D, Brown DL, Andreotti RF, Benacerraf B, Benson CB, Brewster WR, et al. Management of asymptomatic ovarian and other adnexal cysts imaged at US: society of radiologists in ultrasound consensus conference statement. Radiology. 2010; 256:943–954.

22. Kim DC, Bennett GL, Somberg M, Campbell N, Gaing B, Recht MP, et al. A multidisciplinary approach to improving appropriate follow-up imaging of ovarian cysts: a quality improvement initiative. J Am Coll Radiol. 2016; 13:535–541.

23. Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, et al. Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA. 1999; 282:1458–1465.

24. Centre for Evidence-Based Medicine. Oxford Centre for Evidence-based Medicine-Levels of Evidence (March 2009). Web site. Accessed July 15, 2016. http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/.

25. Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin. 2014; 64:9–29.

26. Surveillance, Epidemiology, and End Results Program. SEER Stat Fact Sheets: Ovarian Cancer. Web site. Accessed July 15, 2016. http://seer.cancer.gov/statfacts/html/ovary.html.

27. Martínez-Jiménez S, Rosado-de-Christenson ML, Walker CM, Kunin JR, Betancourt SL, Shoup BL, et al. Imaging features of thoracic metastases from gynecologic neoplasms. Radiographics. 2014; 34:1742–1754.

28. Heintz AP, Odicino F, Maisonneuve P, Quinn MA, Benedet JL, Creasman WT, et al. Carcinoma of the ovary. FIGO 26th annual report on the results of treatment in gynecological cancer. Int J Gynaecol Obstet. 2006; 95:Suppl 1. S161–S192.

29. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology ovarian cancer. Web site. Accessed July 15, 2016. http://www.nccn.org/professionals/physici an_gls/pdf/ovarian.pdf.

30. Kerr VE, Cadman E. Pulmonary metastases in ovarian cancer. Analysis of 357 patients. Cancer. 1985; 56:1209–1213.

31. Mitchell DG, Javitt MC, Glanc P, Bennett GL, Brown DL, Dubinsky T, et al. ACR appropriateness criteria staging and follow-up of ovarian cancer. J Am Coll Radiol. 2013; 10:822–827.

32. Berrington de González A, Kim KP, Berg CD. Low-dose lung computed tomography screening before age 55: estimates of the mortality reduction required to outweigh the radiation-induced cancer risk. J Med Screen. 2008; 15:153–158.

33. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP. 2007; 37:1–332.

34. Shinagare AB, O'Neill AC, SuChun C, Somarouthu B, Tirumani SH, Nishino M, et al. Advanced high-grade serous ovarian cancer: frequency and timing of thoracic metastases and their implications for chest imaging follow-up. Radiology. 2015; 277:733–740.

35. Shinagare AB, Ip IK, Lacson R, Ramaiya NH, George S, Khorasani R. Gastrointestinal stromal tumor: optimizing the use of cross-sectional chest imaging during follow-up. Radiology. 2015; 274:395–404.

36. Joensuu H, Reichardt P, Eriksson M, Sundby Hall K, Vehtari A. Gastrointestinal stromal tumor: a method for optimizing the timing of CT scans in the follow-up of cancer patients. Radiology. 2014; 271:96–103.

37. Joensuu H, Martin-Broto J, Nishida T, Reichardt P, Schöffski P, Maki RG. Follow-up strategies for patients with gastrointestinal stromal tumour treated with or without adjuvant imatinib after surgery. Eur J Cancer. 2015; 51:1611–1617.

38. Khorasani R. Computerized physician order entry and decision support: improving the quality of care. Radiographics. 2001; 21:1015–1018.

39. Rosenthal DI, Weilburg JB, Schultz T, Miller JC, Nixon V, Dreyer KJ, et al. Radiology order entry with decision support: initial clinical experience. J Am Coll Radiol. 2006; 3:799–806.

40. Raja AS, Ip IK, Prevedello LM, Sodickson AD, Farkas C, Zane RD, et al. Effect of computerized clinical decision support on the use and yield of CT pulmonary angiography in the emergency department. Radiology. 2012; 262:468–474.

41. Dunne RM, Ip IK, Abbett S, Gershanik EF, Raja AS, Hunsaker A, et al. Effect of evidence-based clinical decision support on the use and yield of CT pulmonary angiographic imaging in hospitalized patients. Radiology. 2015; 276:167–174.

42. Khorasani R, Hentel K, Darer J, Langlotz C, Ip IK, Manaker S, et al. Ten commandments for effective clinical decision support for imaging: enabling evidence-based practice to improve quality and reduce waste. AJR Am J Roentgenol. 2014; 203:945–951.

43. American College of Radiology. ACR Appropriateness Criteria®. Web site. Accessed June 16, 2016. http://www.acr.org/Quality-Safety/Appropriateness-Criteria.

44. Raja AS, Ip IK, Dunne RM, Schuur JD, Mills AM, Khorasani R. Effects of performance feedback reports on adherence to evidence-based guidelines in use of CT for evaluation of pulmonary embolism in the emergency department: a randomized trial. AJR Am J Roentgenol. 2015; 205:936–940.

45. Silveira PC, Ip IK, Sumption S, Raja AS, Tajmir S, Khorasani R. Impact of a clinical decision support tool on adherence to the Ottawa Ankle Rules. Am J Emerg Med. 2016; 34:412–418.

46. Pons E, Braun LM, Hunink MG, Kors JA. Natural language processing in radiology: a systematic review. Radiology. 2016; 279:329–343.

47. Ip IK, Mortele KJ, Prevedello LM, Khorasani R. Repeat abdominal imaging examinations in a tertiary care hospital. Am J Med. 2012; 125:155–161.

48. Dunnick NR, Langlotz CP. The radiology report of the future: a summary of the 2007 Intersociety Conference. J Am Coll Radiol. 2008; 5:626–629.

49. Samartine S, White L, McKeon D, Becker M. Enhancing structured reporting: improving quality by tailoring the report to the clinical scenario. J Am Coll Radiol. 2015; 12:845–847.

50. Powell DK, Silberzweig JE. State of structured reporting in radiology, a survey. Acad Radiol. 2015; 22:226–233.

51. Larson DB, Towbin AJ, Pryor RM, Donnelly LF. Improving consistency in radiology reporting through the use of department-wide standardized structured reporting. Radiology. 2013; 267:240–250.

52. Kahn CE Jr, Heilbrun ME, Applegate KE. From guidelines to practice: how reporting templates promote the use of radiology practice guidelines. J Am Coll Radiol. 2013; 10:268–273.

53. Kahn CE Jr, Langlotz CP, Burnside ES, Carrino JA, Channin DS, Hovsepian DM, et al. Toward best practices in radiology reporting. Radiology. 2009; 252:852–856.

54. Sahni VA, Silveira PC, Sainani NI, Khorasani R. Impact of a structured report template on the quality of MRI reports for rectal cancer staging. AJR Am J Roentgenol. 2015; 205:584–588.

55. The Joint Commission. 2016 National Patient Safety Goals. Web site. Accessed June 21, 2016. https://www.jointcommission.org/standards_information/npsgs.aspx.

56. Lacson R, O'Connor SD, Andriole KP, Prevedello LM, Khorasani R. Automated critical test result notification system: architecture, design, and assessment of provider satisfaction. AJR Am J Roentgenol. 2014; 203:W491–W496.