Drew Moghanaki: This insightful study by Michael Farris reminds us that communication gaps affect patient care

Drew Moghanaki, Lung Cancer Specialist at UCLA Health Jonsson Cancer Center, shared on X/Twitter:

“I trust that most radiation oncologists appreciate communication gaps affect patient care. This insightful study by Michael Farris reminds us that this principle is true.

In this interdisciplinary study at Wake Forest, 35 radiotherapy treatment plans for patients with locally advanced NSCLC were independently reviewed by a radiologist, specializing in thoracic imaging, to identify potential opportunities to improve the quality of treatment.

In these 3 cases, a radiation oncologist contoured suspected malignancy in red, and the radiologist’s arrow shows uncovered disease that could have been missed without their review.

The article also describes cases where normal anatomic structures were contoured as a tumor structure. For example, here’s a pulmonary vein erroneously contoured as a target.

Here, the arrow points to a pericardial recess, also contoured as a tumor target. I appreciate this is a structure not commonly taught in radiation oncology textbooks.

Finally, a radiation oncologist has contoured a prominent left pulmonic venous recess, again a structure not typically discussed in a radiation oncology department.

How can these contouring errors be avoided? By remembering that even though our patients call us “Radiology Oncologists”, we aren’t actually formally trained in Radiology.

Errors can also be avoided through meticulous understanding of thoracic anatomy and spending more time with radiologists – who like to teach, and are good at it – during our training and as an attending. Screen-sharing technologies has made this easier than ever before!”

Source: Drew Moghanaki/X