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Radiologist role in a multidisciplinary team (MDT)

Your participation in a MDT helps to facilitate early and accurate diagnosis of fibrotic ILDs,1,2 as you may be the first to observe its signs via HRCT3

SUSPECT PULMONARY FIBROSIS

EARLY AND ACCURATE DIAGNOSIS

A MDT approach that includes a radiologist is regarded as the gold standard for diagnosing fibrotic ILDs1,4,5

Multidisciplinary discussion enables integration of all available information, and increases the accuracy of fibrotic ILD diagnosis and prognosis prediction.6

Together with clinical evaluation, patterns of chest HRCT and multidisciplinary discussions facilitate first-choice diagnosis6,7

A MDT approach that includes a radiologist is regarded as the gold standard for diagnosing fibrotic ILDs

BAL, bronchoalveolar lavage; DLCO, diffusion capacity of carbon monoxide; FVC, forced vital capacity; HRCT, high-resolution computed tomography; UIP, usual interstitial pneumonia.
Adapted from: Cottin V, Valenzuela C. Presse Med. 2020;49(2):104021 and Cottin V, et al. Eur Respir Rev. 2018;27(150):180076.

CLEAR COMMUNICATION OF HRCT FINDINGS

Radiological reports should be clear, unambiguous (where possible), structured and communicated efficiently to their recipients8

You have an important role in clearly communicating the diagnostic and prognostic report to the referrer, and increasingly, directly to the patient

You have an important role in clearly communicating the diagnostic and prognostic report to the referrer, and increasingly, directly to the patient8

With patient-centric care, there is an increasing need for patients to be fully informed on relevant information, including radiology findings

With patient-centric care, there is an increasing need for patients to be fully informed on relevant information, including radiology findings8

The reports should include:8,9

  • List of findings
  • Actionable and practical suggestions for patient care and management

Standardized HRCT reporting can help reduce the risk of under-reporting important findings of chest HRCT10


Example of a structured list of findings in a standardized HRCT report10

Example of a structured list of findings in a standardized HRCT report

BAL, bronchoalveolar lavage; CT, computed tomography; FLD, fibrosing lung disease; HP, hypersensitivity pneumonitis; HRCT, high-resolution computed tomography; ILD, interstitial lung disease; NSIP, non-specific interstitial pneumonia; OP, organizingpneumonia; PPFE, pleuroparenchymal fibroelastosis; UIP, usual interstitial pneumonia.
Adapted from: Sverzellati N, et al. Radiol Med. 2018;123(4):245–253.
 

Standardized HRCT reporting may improve communication of HRCT findings that inform fibrotic ILD diagnosis and clinical decisions.10–12

Standardized HRCT reporting in suspected cases of ILDs helps to:11,12

  • Improve the readability of reports and reduce ambiguous language
  • Decrease variability of reports
  • Improve compliance with current national ILD reporting guidelines
  • Increase the likelihood of making a specific HRCT diagnosis when possible

Work closely with referrers to clearly communicate the significance of key radiological findings and support effective clinical decisions8,10–12

Footnotes

BAL, bronchoalveolar lavage; CT, computed tomography; DLCO, diffusion capacity of carbon monoxide; FLD, fibrosing lung disease; FVC, forced vital capacity; HP, hypersensitivity pneumonitis; HRCT, high-resolution computed tomography; ILD, interstitial lung disease; MDT, multidisciplinary team; NSIP, non-specific interstitial pneumonia; OP, organizing pneumonia; PPFE, pleuroparenchymal fibroelastosis; UIP, usual interstitial pneumonia.

  1. Walsh SLF. Multidisciplinary evaluation of interstitial lung diseases: current insights. Eur Respir Rev. 2017;26:170002.
  2. De Sadeleer LJ, Meert C, Yserbyt J, et al. Diagnostic ability of a dynamic multidisciplinary discussion in interstitial lung diseases: A retrospective observational study of 938 cases. Chest. 2018;153(6):1416–1423.
  3. Doyle TJ, Hunninghake GM, Rosas IO. Subclinical interstitial lung disease. Am J Respir Crit Care Med. 2012;185:1147–1153.
  4. Furini F, Carnevale A, Casoni GL, et al. The role of the multidisciplinary evaluation of interstitial lung diseases: systematic literature review of the current evidence and future perspectives. Front Med (Lausanne). 2019;6:246.
  5. De Lorenzis E, Bosello SL, Varone F, et al. Multidisciplinary evaluation of interstitial lung diseases: new opportunities linked to rheumatologist involvement. Diagnostics (Basel). 2020;10(9):664.
  6. Cottin V, Valenzuela C. Diagnostic approach of fibrosing interstitial lung diseases of unknown origin. Presse Med. 2020;49(2):104021.
  7. Cottin V, Hirani N, Hotchkin D, et al. Presentation, diagnosis and clinical course of the spectrum of progressive-fibrosing interstitial lung diseases. Eur Respir Rev. 2018;27(150):180076.
  8. European Society of Radiology (ESR). The role of radiologist in the changing world of healthcare: a White Paper of the European Society of Radiology (ESR). Insights Imaging. 2022;13(1):100.
  9. Brady A. Incidentalomas, SPEW, and VOMIT—radiological dyspepsia? Eur Radiol. 2020;30(9):4968–4973.
  10. Sverzellati N, Odone A, Silva M, et al. Structured reporting for fibrosing lung disease: a model shared by radiologist and pulmonologist. Radiol Med. 2018;123(4):245–253.
  11. Berkowitz EA, Bernheim A, Little BP. Introducing ILD-RADS: a pilot study of an interstitial lung disease standardized reporting template. J Am Coll Radiol. 2019;16(9 Pt A):1169–1172.
  12. Irion KL, Souza Jr AS, Marchiori E, da Silveira Dalla-Bona JP, Hochhegger B. Assessment of pulmonologists’ receptivity to a structured radiology report for interstitial lung disease. J Bras Pneumol. 2020;46(5):e20200164.  

 

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