One-Stop Triple Imaging: The Way Forward in Head and Neck Cancer Management?

Randhawa, P S; Jie, Jiang; Lechner, Matt; Rimmer, Joanne; Beale, Tim; Morley, Simon; Vaz, Francis

doi:10.1308/003588413x13625648805325

Cited by 4 publications

(13 citation statements)

References 7 publications

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“…10 A 2013 review reported a reduction in days to diagnosis from referral date from 25.4 to 16.5 days after the introduction of same-day computed tomography and magnetic resonance imaging, which are carried out in addition to inclinic FNAC, if necessary. 11 This could be introduced at King's College Hospital if supported by financial and operational resources.…”

Section: Discussionmentioning

confidence: 99%

The role of core needle biopsies in the management of neck lumps

Kalra

Prucher

Hodges

2019

annals

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Introduction King’s College Hospital has proudly provided a one-stop neck lump clinic since 2012. These multidisciplinary clinics allow for rapid diagnoses due to in-clinic investigations. In April 2013, ultrasound-guided core needle biopsies were introduced as an alternative/adjunct to fine-needle aspiration cytology and open biopsies for obtaining histological diagnoses. The aim of the study was to assess the impact of core needle biopsies on the diagnosis of neck lumps compared with fine-needle aspiration cytology and open biopsies between April 2015 and May 2016. Materials and methods Data were collected prospectively between April 2015 and May 2016 and analysed for numbers of fine-needle aspiration cytology, core needle biopsies and open biopsies performed and diagnoses made. Results A total of 190 patients were seen on the clinic; 51 had fine-needle aspiration cytology and 19 procedures gave a diagnosis. Of the remainder of these patients, 21 went on to have a core needle biopsy and 12 biopsies gave a diagnosis. An additional eight patients only had a core needle biopsy, of which five biopsies gave a diagnosis. Of the ten patients who had an open biopsy, four had a previous fine-needle aspiration cytology and core needle biopsy, three only a core needle biopsy, two had neither and one had fine-needle aspiration cytology. Conclusion The introduction of core needle biopsies has reduced the number of open biopsies performed. With increasing acceptance of this minimally invasive technique, core needle biopsies appear to be forming the key diagnostic investigation in patients with neck lumps.

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Section: Discussionmentioning

confidence: 99%

The role of core needle biopsies in the management of neck lumps

Kalra

Prucher

Hodges

2019

annals

View full text Add to dashboard Cite

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“…Fifteen studies evaluated the impact of a multidisciplinary clinic-based intervention whereby patients were seen by a multidisciplinary clinic to reduce the need for separate appointments. Study type varied: nine were retrospective audits, [26][27][28][29][30][31][32][33] three were before-and-after studies, [34][35][36] two were prospective audits, 37,38 and one was a retrospective cohort study. 39 One study did not have sufficient information as to the study type.…”

Section: Description Of Studies and Interventionsmentioning

confidence: 99%

“…39 One study did not have sufficient information as to the study type. 40 Seven studies were conducted in the United States, 26,27,30,35,36,39,40 five in England, 29,31,33,37,38 and one each in Australia, 28 Poland, 34 and the Netherlands. 32 Nine studies 27,30,32,[34][35][36][38][39][40] evaluated a multidisciplinary clinic, five of which 30,32,36,39,40 specified a single-day or "one-stop" multidisciplinary clinic.…”

Section: Description Of Studies and Interventionsmentioning

confidence: 99%

“…32 Nine studies 27,30,32,[34][35][36][38][39][40] evaluated a multidisciplinary clinic, five of which 30,32,36,39,40 specified a single-day or "one-stop" multidisciplinary clinic. Two studies 31,37 evaluated interventions focusing on imaging services (one a multidisciplinary-led imaging booking service 37 and one a "triple imaging radiology service"). 31 The remaining studies evaluated telemedicine for remote patients, 26 live-documentation of multidisciplinary team (MDT) meetings with pro-forma, 28 and use of pro-forma referral letters.…”

Section: Description Of Studies and Interventionsmentioning

confidence: 99%

“…Two studies 31,37 evaluated interventions focusing on imaging services (one a multidisciplinary-led imaging booking service 37 and one a "triple imaging radiology service"). 31 The remaining studies evaluated telemedicine for remote patients, 26 live-documentation of multidisciplinary team (MDT) meetings with pro-forma, 28 and use of pro-forma referral letters. 29,33 Descriptions of intervals measured in studies varied greatly and often overlapped.…”

Section: Description Of Studies and Interventionsmentioning

confidence: 99%

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Interventions to reduce times to diagnosis and treatment of head and neck cancer: A systematic review and narrative synthesis

et al. 2023

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Background We systematically reviewed evidence of health system interventions to reduce diagnostic and treatment intervals for people with head and neck cancer (HNC). Methods Electronic databases were searched from inception to 30 April 2020 for controlled or uncontrolled comparative studies. Primary outcome was any time interval between first clinical presentation and treatment onset. Results Thirty‐seven studies were included. Four types of interventions were identified: single clinic‐based (N = 4), multidisciplinary clinic‐based (N = 15), hospital or service re‐design (N = 12), and health system re‐design (N = 6). There was some evidence that multidisciplinary interventions improve timeliness of diagnosis and treatment; however, evidence of long‐term effectiveness was lacking. Study quality was assessed as either low or moderate. Conclusions Interventions to reduce times to diagnosis and treatment of HNC are heterogeneous, with limited evidence of effectiveness. Future interventions should account for the complex and dynamic nature of health systems and adhere to best‐practice principles for early‐diagnosis research.

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Rethinking the ‘one-stop’ neck lump clinic: a novel pathway beyond coronavirus disease 2019

et al. 2023

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Objectives UK guidelines advocate ‘one-stop’ neck lump assessment for cancer referrals. This paper reports the pilot of a novel pre-clinic ultrasound pathway, presents outcomes, and discusses strengths and limitations in the context of the coronavirus disease 2019 pandemic. Methods Two-week-wait cancer referral patients with a neck lump were allocated a pre-clinic ultrasound scan followed by a clinic appointment. Demographic, patient journey and outcome data were collected and analysed. Results Ninety-nine patients underwent ultrasound assessment with or without biopsy on average 8 days following referral. Patients were followed up on average 14.1 days (range, 2–26 days) after initial referral. At the first clinic appointment, 45 patients were discharged, 10 were scheduled for surgery, 12 were diagnosed with cancer, 6 were referred to another specialty and cancer was excluded in 19 patients. Retrospectively, four ultrasounds were performed unnecessarily. Conclusion Pre-clinic ultrasound scanning is an alternative to the one-stop neck lump pathway. This study demonstrates fewer clinic visits, faster diagnosis and a low proportion of unnecessary scans, whilst minimising face-to-face consultations and aerosol-generating procedures.

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One-Stop Triple Imaging: The Way Forward in Head and Neck Cancer Management?

Abstract: Head and neck (H&N) cancer affects approximately 8–15 per 100,000 of the UK population. It has been suggested that the delay in diagnosing cancer has been a major factor in the poorer survival rates in the UK compared with some other countries in Europe.

Cited by 4 publications

References 7 publications

The role of core needle biopsies in the management of neck lumps

The role of core needle biopsies in the management of neck lumps

Interventions to reduce times to diagnosis and treatment of head and neck cancer: A systematic review and narrative synthesis

Rethinking the ‘one-stop’ neck lump clinic: a novel pathway beyond coronavirus disease 2019

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