Automated triage to a virtual lung nodule clinic using Veye Lung Nodule volumetry provides a cost saving compared to standard care

Abstract Objectives Pulmonary nodules are frequently identified on thoracic CT imaging, with management guided by established clinical pathways. Thoracic CT scans are reported by both specialist and general radiologists. This study evaluated discordance in pulmonary nodule identification and management between general and specialist radiologists and modelled automated triage to a virtual nodule clinic. Materials and methods All CT scans including the thorax performed over a one-week period at a single UK centre in March 2022 were identified and original reports reviewed. Oncology follow-up scans were excluded. Reports were categorised and compared with an independent second expert radiologist review. Virtual nodule clinic (VNC) triage pathways were modelled to select patients for second review by an expert radiologist. The pathways used combinations of original radiologist reports and automated nodule assessment (DeepHealth Ltd) to trigger VNC review. The cost implications of each pathway were calculated. Results Among 243 CT scans, 98 (40%) original reports identified a pulmonary nodule. Expert review identified incorrect recommendations in 24/243 (10%) cases. Errors were significantly more frequent in reports issued by general radiologists compared with specialist thoracic radiologists (χ²≈11.0, df = 2, p < 0.05). VNC triage pathways that selected cases for secondary review when automated nodule assessment failed to identify a nodule that was identified by the reporting radiologist resulted in the greatest cost savings per corrected nodule. Conclusion Approximately 10% of thoracic CT scans contained errors in pulmonary nodule reporting. Cost-saving triage pathways combining non-specialist reporting with automated nodule assessment appear feasible and warrant prospective real-world validation. Advances in knowledge