Purpose: To examine the current radiographic follow-up recommendations of thoracic radiologists after detection of a new opacity, suspected to be "pneumonia," on chest radiography.
Materials and methods: An anonymized, Institutional Review Board-approved, Internet-based survey was sent to the 735 members of the Society of Thoracic Radiology by e-mail. Questions focused on individual practices and institutional policies after radiographic detection of suspected pneumonia. Univariate and multivariable logistic regression analyses were used to evaluate for possible associations between recommendation practices and demographic variables, various clinical situations, and radiographic features.
Results: Of the 209 radiologists who responded, 42% "always" recommended follow-up radiographs for new opacities detected on chest radiographs, 55% "sometimes" recommended follow-up, and 2% "never" recommended follow-up. Univariate logistic regression analysis revealed that "years in practice" (P=0.0043) and "number of outpatient posterior-anterior and lateral chest radiographs interpreted per week" (P=0.027) were significant predictors of the recommendation practices. In addition, the multivariable logistic regression analysis pointed to the type of practice (academic vs. private) as an additional independent predictor of the recommendation practices (P=0.0294). The recommendations of those radiologists recommending follow-up "sometimes" were most often influenced by the radiographic appearance of the opacity and patient age. Only 4% reported an institutional policy.
Conclusions: The majority of responding radiologists recommended follow-up on a case-by-case basis, influenced by multiple factors. Only a small minority reported a standardized practice at their institution. This lack of consistency demonstrates the need for a uniform, evidence-based approach.