Turning Around Cancer: Oncologic Imaging and Implications for Emergency Radiology Workflow

Thursday, Nov. 29 11:50AM - 12:00PM Room: E451B

Student Travel Stipend Award

Marc D. Succi, MD, Boston, MA (Presenter) Patent agreement, Frequency Therapeutics, LLC; Patent agreement, AugMI Labs, Inc; Stockholder, 2 Minute Medicine
Brian J. Yun, MD, Boston, MA (Abstract Co-Author) Nothing to Disclose
Ravi V. Gottumukkala, MD, Boston, MA (Abstract Co-Author) Nothing to Disclose
McKinley Glover IV, MD, Boston, MA (Abstract Co-Author) Nothing to Disclose
Jonathan Sonis, MD, Boston, MA (Abstract Co-Author) Nothing to Disclose
Stephen C. Dorner, MD, Boston, MA (Abstract Co-Author) Nothing to Disclose
Benjamin A. White, MD, Boston, MA (Abstract Co-Author) Nothing to Disclose
Michael H. Lev, MD, Boston, MA (Abstract Co-Author) Consultant, General Electric Company; Institutional research support, General Electric Company; Stockholder, General Electric Company; Consultant, MedyMatch Technology, Ltd; Consultant, Takeda Pharmaceutical Company Limited; Consultant, D-Pharm Ltd
Ali S. Raja, MD, Boston, MA (Abstract Co-Author) Nothing to Disclose
Anand M. Prabhakar, MD, Somerville, MA (Abstract Co-Author) Nothing to Disclose

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Oncology patients comprise a substantial portion of the patient population served by academic hospitals. As a result, academic ED radiology departments are performing an increasing number of oncologic imaging studies, including non-acute staging studies to assess disease status. We assessed how performing and reading non-acute oncologic examinations affects ED radiology workflow and turnaround time (TAT), as defined by the time from imaging start to final signed radiologist interpretation.


We retrospectively identified all patients on whom computed tomography (CT) was performed and interpreted in a quaternary hospital ED during the period from February 2016 to September 2017. Any CT exam order history containing cancer descriptors were included. Subsequently, chart review was performed, with assessment of free text entered by ordering physicians to determine if CT indication was related to acute presentation. All CTs performed for routine acute ED indications, and not primarily oncologic staging, were excluded. A matched cohort of routine ED CT exams during the same period was identified. We then performed a multivariate log-transformed linear regression to compare TATs.


Following adjustment for age and CT imaging code, oncologic CTs were independently associated with an increased log TAT compared to the log time to interpretation for routine ED CTs (114.5 mins (IQR 112) versus 69 mins (IQR 67), respectively, p<0.0001). Average age, examination duration, time from initial order to scan completion, and time from scan completion to image availability in PACS did not significantly differ between the oncologic imaging group and the matched non-oncologic cohort.


Non-acute oncologic staging CTs in the ED are associated with a significantly longer TAT compared to routine ED CT examinations. This has important implications for how hospitals, especially quaternary care institutions, can improve workflow and reduce TATs by triaging non-acute oncologic imaging examinations to non-ED imaging divisions.


Oncology patients who present to the emergency department (ED) are frequently imaged. We assessed the impact of non-acute oncologic imaging performed in the ED on emergency radiology workflow.