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Simrun Flora



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    P3.11 - Screening and Early Detection (Not CME Accredited Session) (ID 977)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.11-21 - The Development of a Robust Radiology Quality Assurance (QA) Program in a Provincial High-Risk Lung Cancer Screening Pilot (HRLCSP) (ID 13811)

      12:00 - 13:30  |  Author(s): Simrun Flora

      • Abstract
      • Slides

      Background

      Lung cancer is the leading cause of cancer death in Ontario, with an estimated 7100 patient deaths occurring in 2016 (Canadian Cancer Society, 2016). Based on results from the National Institute of Health’s National Lung Screening Trial, Cancer Care Ontario (CCO) implemented the HRLCSP in 2017 to determine feasibility of provincial scale roll-out of an organized lung cancer screening program. An integral component of the HRLCSP is to ensure low-dose computed tomography (LDCT) scans would be performed, interpreted and reported in a standardized, and high-quality manner.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      The HRLCSP project team coordinated with CCO’s Cancer Imaging Program (CIP) to gain insight into cancer imaging practices and protocols, and recruited clinical expertise through a Radiology QA Clinical Lead (RQACL). In collaboration with pilot site radiologists, a comprehensive QA program was developed to encompass all aspects of radiology including facility, educational, and reporting standards, in addition to defining quality improvement criteria.

      4c3880bb027f159e801041b1021e88e8 Result

      To ensure pilot centres were able to deliver high-quality LDCTs, the RQACL, site participants and clinical experts collaborated to define and implement quality parameters. Equipment standards were defined in The Radiology QA Program Manual, and agreement from pilot sites was confirmed. Collaboration with reading radiologists led to tailored educational workshops designed to ensure consistency in the reporting of lung nodules based on the Lung-RADS™ scoring criteria, adapted from the American College of Radiology. Scan interpretation considerations, scoring criteria, and reporting templates were implemented. Annual assessments have ensured compliance across pilot sites. A working group aiming to determine an algorithm to examine incidental findings is being created. LDCT scan Double Read minimums and Peer Review adjudication processes were developed to ensure expert opinion availability with radiologist discrepancies to ensure high quality scan interpretation.

      8eea62084ca7e541d918e823422bd82e Conclusion

      The design of the HRLCSP offered opportunities for implementing high quality standards around the LDCT scans. Implementation of a robust quality assurance program can ensure that the radiology component is delivered in a high-quality manner. Radiologist training programs, centre minimum requirements, and standardized reporting can ensure standards remain high. Lessons learned through the development of this comprehensive radiology QA program in the HRLCSP will allow for adoption of high-quality radiology standards on a larger provincial scale.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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