1 / 12

Radiology 2WW

Radiology 2WW. Dr Mandy Williams Head and Neck Radiology Cons UHB April 2019. Numbers of scans. Increasing numbers of USS and MRI generally inc 2ww. USS/ Biopsy needed ( 2019 data) Jan-70 (18) Feb -53 (13) March-69 (31)

ppeeples
Download Presentation

Radiology 2WW

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Radiology 2WW Dr Mandy Williams Head and Neck Radiology Cons UHB April 2019

  2. Numbers of scans • Increasing numbers of USS and MRI generally inc 2ww. • USS/ Biopsy needed ( 2019 data) • Jan-70 (18) • Feb -53 (13) • March-69 (31) • Total as 2ww 192 USS with 62 bx ( 32% needed biopsy/FNA). 68% no biopsy

  3. USS non 2wwUrgent- • Jan 79 16Bx • Feb 74 15 • March 43 11 • Total 196 42 ( 21%)

  4. Routine USS • Jan 130 12bx • Feb 105 8 • March 113 11 • Total 348 32 biopsies ( 9%)

  5. USS • Total USS Jan-March 2019 • 736 neck USS of which 192 2ww 26% • 135 biopsies-53 as 2ww 45%

  6. MRI neck • 2 types depending on history. • If no mass seen on FNE or felt / low suspicion. • MRI neck ( 20 min scan) • If mass seen/ felt or clinical suspicion high MRI neck with gad. 40 min scan with additional sequences.

  7. MRI neck/gad2ww MRI neck MRI neck with gad Total • Jan 18 23 41 • Feb 53 24 77 • March 42 42 84 • Total 113 89 202

  8. MRI neck-low suspicion. • Total Jan-March-113 • Suspicious features/ malignancy-6. • One known parotid mass, others incidental findings or large tonsils. • One hypopharyngeal cancer with nodes. • Malignancy pick up rate 1/113- <1%

  9. MRI neck with gad-suspicious findings on FNA/ history. • Total scans Jan –March 89 • Total with suspicious findings- 49 • 55% abnormal- some of these staging MRI for known cancer.

  10. Summary • Very low pick up of unexpected cancers for patients with normal ENT examination and you request an MRI neck. • ? Downgrade these patients to urgency 5 and take OFF the 2ww pathway. Advising them in clinic they Don’t have cancer.

  11. USS • 68% of 2ww neck USS are normal and many others have FNA of low risk salivary cancers and thyroid nodules. • If low risk again suggest these patients are taken off the pathway. • Clinical examination is good for neck lumps. • If you think it is a lipoma/ sebaceous cyst/ thyroglossal cyst –it will be on USS too.

  12. High risk patients • Often wait too long for investigations. • If mass present then should have USS/MRI/CT within a week and panendoscopy. • This is achievable if we remove non urgent 2WW off this pathway at clinic stage and tell the patient they Do NOT have cancer and do the scans urgently ( 3-4 weeks). Most wont need follow up in clinic either.

More Related