title: A diagnostic program for patients suspected of having lung cancer.
abstract: BACKGROUND
  A standardized diagnostic program, initiated to reduce the length of the diagnostic track and to improve application of diagnostic tools for patients referred with suspicious abnormalities on standard chest radiographs, was evaluated.
  
  
  METHODS
  The findings on integrated positron emission tomography/computed tomography (PET-CT) determined the choice of invasive investigations to be performed the same day. Diagnostic results, time courses, and number and sorts of applied invasive investigations were assessed.
  
  
  RESULTS
  In 297 eligible patients, malignant disease was diagnosed in 72% and benign disease was diagnosed in 26% of patients. One percent of the patients had no abnormalities at all. For 85% of patients with malignancy, investigations were completed in 1 day, resulting in a diagnosis and definitive clinical disease stage. The median time from start of the analysis to informing the patient about diagnosis and tumor stage was 7 days. One invasive investigation was performed in 53% of patients in the study group, and at least 2 investigations were performed in 33% of patients. Bronchoscopies formed a part of the diagnostic process in 59% of patients. Surgical diagnostic procedures were performed in 8% of patients.
  
  
  CONCLUSIONS
  The diagnostic program resulted in a short time to diagnosis, with finalization of invasive investigations in 1 day in the majority of patients. The imaging-based choice of invasive investigations precluded bronchoscopies in a substantial portion of the patients.
authors.affiliation: Department of Pulmonology, Isala Klinieken, Zwolle, the Netherlands. j.a.stigt@isala.nl
authors.forename: Jos A
authors.initials: JA
authors.lastname: Stigt
authors.forename: Steven M
authors.initials: SM
authors.lastname: Uil
authors.forename: Ad H
authors.initials: AH
authors.lastname: Oostdijk
authors.forename: James E
authors.initials: JE
authors.lastname: Boers
authors.forename: Jan-Willem K
authors.initials: JW
authors.lastname: van den Berg
authors.forename: Harry J M
authors.initials: HJ
authors.lastname: Groen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*