Computed tomography (CT) imaging of the chest is performed as part of the assessment of patients with oral cancer to exclude pulmonary metastasis or synchronous cancer. This process is integral to staging of the disease. In some cases, non-specific pulmonary nodules are identified and depending on the size of the nodules, follow up imaging may be recommended by the multi-disciplinary team. The interval scanning could range between 3 to 12 months’ time depending on the Fleischner Society recommendations for management of nodules that are smaller than 8mm. The authors aimed to audit their practice to see if follow-up CT imaging was actually performed as recommended and to ascertain the outcome of the patients.
During the three years studied retrospectively, the authors found 49 patients (11.9%) had abnormal CT chest findings that required follow-up imaging of the chest. However, they found only 20 (40%) patients had follow up-imaging.
Of the patients who were followed up, 11 (55%) patients had either a primary chest malignancy or metastasis or increasing size of the chest nodules. The authors identified areas for improvement in ensuring patients have their surveillance imaging, such as sending recommendations from MDT to the patient’s general practitioner and their referring hospitals. The authors also advocate informing patients of the need for follow-up imaging and to encourage them to pursue this if it is not already performed.