Dedicated Diagnostic Radiology/Radiation Oncology Rounds: Added Value Beyond Traditional Tumor Boards
Publication date: Available online 9 May 2019
Source: Current Problems in Diagnostic Radiology
Author(s): Kimberly G. Kallianos, Bannet N. Muhoozi, Alexander Gottschalk, Sue S. Yom, Jason W. Chan, Travis S. Henry, Brett M. Elicker, Karen G. Ordovas, David M. Naeger

Abstract

Objectives

We aimed to evaluate the impact of collaborative discussion between diagnostic radiologists and radiation oncologists on radiation oncology management for thoracic oncology patients.

Methods

We reviewed cases presented at multidisciplinary thoracic tumor boards (TTB) (n=122) and diagnostic radiology/radiation oncology rounds (DR/ROR) (n=45). Changes in planned radiation management following imaging discussion were categorized - no change, timing change, and treatment volume change. Phase of care was also classified. In DR/ROR, radiation oncologists were surveyed regarding 1) change in radiation oncology management and 2) change in confidence (both 5-point Likert scales).

Results

Discussion of imaging with a radiologist changed radiation oncology management in 31.1% of TTB cases and 68.9% of DR/ROR cases (p<0.001). Changes to the timing of initiating radiation therapy occurred with similar frequency in the two settings (31.1% vs 46.7%, p=0.063). Changes to target volume occurred more frequently in DR/ROR, (35.6% vs <1%), p<0.001. Over half of imaging discussions in DR/ROR resulted in at least “moderate” change in radiation oncology management, and the level of confidence held by the radiation oncologists increased following discussion with radiologists in 95.6% of cases.

Conclusion

Collaborative discussions between radiation oncologists and diagnostic radiologists in a multi-specialty tumor board and in targeted two-specialty rounds are not redundant, but result in different management changes and at different phases of care. Our study emphasizes the importance of consultation with physicians as an area where radiologists can add value, specifically the added benefit of smaller collaborative discussions.