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Scientific Session 05 — SS05: Chest Imaging - Lung Nodules, Neoplasms, Staging and Screening

Monday, May 6, 2019

Abstracts 1696-3134

2930. Increased Downstream Testing in Lung Cancer Screening Patients During Flu Season

Hussaini S*,  Yaddanapudi K,  Plank A,  Reagan L. Stony Brook University, Stony Brook, NY

Address correspondence to S. Hussaini (

Objective: To determine if there is an increase in short-term follow-up imaging and increased false-positive downstream testing for lung cancer screening performed during flu season compared to the rest of the year.

Materials and Methods: We performed a retrospective chart review of 765 low-dose lung screening CT scans (LDCT) performed between 2015 and 2017 (encompassing two flu seasons). This review included 320 scans in the year 2015-2016 and 445 in 2016-2017, which were divided into flu season (as defined by the CDC) and rest of the year. Short-term follow-up was defined as repeat CT obtained at 3- or 6-month intervals for lung RADS 3 and 4. The results of repeat scan at 3 or 6 months were evaluated to document resolution. We investigated differences in scheduling between the two years to account for any differences. It was discovered that our schedulers began screening patients for signs/symptoms of recent or current viral or other illness prior to their appointment for LDCT. If a patient did have a recent or current illness their appointment was rescheduled for a time after treatment/resolution.

Results: In the 2015–2016 cohort, 38 out of 237 (16%) screened during flu season required short-term follow-up compared to 10 out of 83 (12%) screened during rest of the year. In the 2016–2017 cohort, 31 out of 293 (10.6%) screened during flu season required short-term follow-up compared to 20 out of 152 (13.2%) screened during the rest of the year. Of the short-term follow-up during the 2015–2016 flu season, 84% had resolution of findings suggesting infection or inflammation. During flu season in 2016–2017, 80% had resolution on follow-up scan.

Conclusion: A 4% increased downstream short-term CT testing was noted in the 2015–2016 flu season compared to the rest of the year. Most of the CT findings (84%) resolved on short-term follow-up suggestive of infection or inflammation. This trend reversed after schedulers began screening patients for recent or current illness prior to their appointment. The result was a decrease in downstream testing by 5.4% between the two consecutive flu seasons. Simple interventions such as rescheduling during acute illness will help avoid some downstream testing that incurs radiation burden, unnecessary interventions, and cost.