Modern cancer care urgently demands new approaches. Lives are at risk, and an ever increasing number of cancer patients and complex examinations constitute more of the radiologist’s workload than ever before. Faster and more accurate diagnoses clearly support the end goal—better patient care—but precisely how to achieve this has proven elusive.
We spoke with key opinion leaders from the U.S., Netherlands, Sweden, and the U.K. to better understand the changes affecting radiology, and listened as they weighed in on the most important challenges and developments in the field.
Opportunities exist not only for radiology to improve traditional reading and reporting functions, but also, critically, to further the new collaborative paradigm that puts radiology at the forefront of diagnosis and patient management.
I invite you to read what these experts have to say.
Key opinion leaders who have contributed to this article include:
- Professor Dr. Paul van Diest, head of the Department of Pathology at University Medical Centre Utrecht in the Netherlands
- Dr. Brendan Devlin, consultant radiologist and former lead radiologist of NIPACS in Northern Ireland
- Dr. Stamatia Destounis, Fellow of the American College of Radiology and Partner at Elizabeth Wende Breast Care in Rochester, New York
- Shannon Demay, PACS Administrator at Elizabeth Wende Breast Care in Rochester, New York
- Gustav Alvfeldt, Information Architect and Project Manager with the Stockholm County Council, Sweden
Four strategically important areas emerged where radiology can bring about better cancer care:
- Developing and facilitating closer collaboration with other departments, especially pathology
- Improving reading efficiency
- Expediting the creation of more actionable reports
- Investing in an information infrastructure with a consolidated patient archive and cross-enterprise workflow
Area 1: Developing and facilitating closer collaboration with other departments, especially pathology
Integrated diagnostics is a powerful new concept in cancer care. Professor Dr. Bruce A. Friedman, Emeritus Professor of Pathology at the University of Michigan Medical School, defined integrated diagnostics in a 2012 presentation as “the seamless collaboration among the diagnostic specialists, most notably pathologists and radiologists.” The goals of integrated diagnostics are straightforward: “To reduce the time and expense of diagnostic processes and provide clinicians with practical and actionable results.” These simple, recognizable goals come with tantalizing theorized rewards, including radically reducing the time from when a patient first walks into a practice to final diagnosis from weeks to days.
Professor Dr. Paul van Diest, head of the Department of Pathology at University Medical Centre Utrecht, talks about what integrated diagnostics could actually look like in practice:
This is something that we started about a year ago. We are starting to get a feeling that there is added value in bringing together diagnostic information from different laboratory disciplines and trying to make more sense of the data, rather than just looking at individual data from individual departments…it’s based on bringing diagnostic information together from different disciplines and trying to look for added value, so you need algorithms that mine these data and find patterns that point to diseases or diagnoses in a better way.
Will integrated diagnostics actually come to pass, or will it remain merely theoretical? Prof. van Diest answers: “It’s complicated, yes, but it’s gaining more and more momentum—more and more people are starting to talk about this in different parts of the world. The time is right to start doing this.”
Before integrated diagnostics can step out of the realm of theory, pathology and radiology must collaborate more closely than they do today. Streamlined communication of concepts and images between radiology and pathology facilitates the work of both departments. Prof. van Diest elaborates:
The first step in the chain is always imaging, and the second step is usually tissue or cellular diagnosis. Now there always needs to be feedback between the two disciplines: pathologists need to check whether the biopsy was representative by correlating back to the images, and radiologists like to know, if they made a diagnosis, that it’s correct; we like to see their results and they like to see ours. So the closer we bring them together, the lower the threshold is to look at each other’s results