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The Fleischner Society produced guidelines in 2005 and 2013 for the follow-up of indeterminate solid and nonsolid pulmonary nodules on CT brought into UK context by the British Thoracic Society in 2015. Suggestions from the BTS are for those over 18 years of age with lung nodules identified by CXR or CT.
Where chest radiographs (CXR) are requested without reference to previous images or reports, there is a risk of an unnecessary, unjustified medical exposure being performed. Failure to check imaging history (has it been done already?) breaches IR(ME)R and is highlighted in the annual CQC report of IR(ME)R regulatory activity.
Many patients in intensive care require multiple chest radiographs on subsequent days. Where the exposure factors are documented and reviewed prior to subsequent examinations, there have been unnecessary repeats of these examinations where under or over exposure may be avoided.
RFA uses heat to locally destroy tumour tissue. The lung is a common treatment site. More regional centres are developing a service and careful audit of success and complications is required.
An urgent referral for a chest X-ray should be made by a primary health care professional (General Practitioner – GP) when a patient presents with unexplained symptoms and signs suggestive of lung cancer. The investigation should be performed (and presumably reported) within 2 weeks of request.
Imaging of suspected pulmonary embolism (PTE) in pregnancy is a difficult clinical decision. This is because the symptoms are common and non-specific and the definitive investigation exposes the mother and the foetus to ionizing radiation. The aim of this audit is to assess the appropriateness of CTPA and isotope lung perfusion examinations performed and ensure that appropriate protocol has been followed.
Find more information on how to produce and submit an audit template, and the submission form.
This page tells you the terms of use on which you may make use of the The Royal College of Radiologists Clinical Radiology AuditLive area (‘AuditLive’) of the website of The Royal College of Radiologists (‘RCR’). Please read these terms of use carefully before you start to use AuditLive. By using AuditLive, you indicate that you accept these terms of use and that you agree to abide by them. If you do not agree to these terms of use, please refrain from using AuditLive.
Information about AuditLive
AuditLive is an area of the RCR website designed to promote and support audit for departments of clinical radiology in the UK. The area provides audit templates which users of the RCR website can read, print, and download and adapt for local use. Audit templates have been derived from the previously published RCR publications Clinical Audit in Radiology 100+ Recipes (1996), Clinical Governance and Revalidations: A Practical Guide for Radiologists (2000) and from new audit templates submitted under these terms and conditions by members and Fellows. All audits published are under the editorial control of the Clinical Radiology Audit Sub-committee of the RCR Board of the Faculty of Clinical Radiology.
Accessing AuditLive
Access to AuditLive is permitted on a temporary basis, and we reserve the right to withdraw or amend the service we provide on AuditLive without notice (see below). We will not be liable if for any reason AuditLive is unavailable at any time or for any period.
You must treat your member login details as confidential, and you must not disclose this information to any third party. We have the right to disable any user identification code or password at any time, if in our opinion you have failed to comply with any of the provisions of these terms of use or the provisions of the Terms of Use for Submissions to AuditLive.
You are responsible for making all arrangements necessary for you to have access to AuditLive. You are also responsible for ensuring that all persons who access our site through your internet connection are aware of these terms, and that they comply with them.
Intellectual property rights
All users are asked to respect the generosity of the contributors who have submitted individual audits. Whilst it is easy to copy material which appears on web sites, it is not legal to do so. The entire contents of AuditLive are protected by copyright laws. The RCR is the owner of the copyright, except where otherwise indicated. AuditLive is for professional healthcare, personal educational and non-commercial use within clinical radiology in the UK. Any other use requires the written permission of the RCR. All proprietary notices on any material downloaded from AuditLive for professional healthcare, personal educational and non-commercial use must not be changed or deleted. If the RCR is using copyrighted material inappropriately, copyright holders should contact us immediately.
If the material from AuditLive is used for personal educational purposes in your personal published or presented work, or if it is used to develop local audit materials within your healthcare institution, due acknowledgement must be given to any sources quoted and the RCR. All copyright watermarks on any images must be left intact. Images and text may be used for other non-commercial purposes by express permission of the RCR only. Any excerpts used for personal educational purposes must be reproduced accurately and not be used in a derogatory manner or in a misleading context. No one may copy, distribute, show in public or create any derivative work from the AuditLive, or any of the material found within it, unless properly licensed by the RCR to do so.
You must not use AuditLive for any purpose prohibited by these terms and conditions. You agree to use this site for lawful purposes only and also agree not to use AuditLive in such a way that it would disable or impair any of the services and so restrict or inhibit the use of or enjoyment of the site by third parties.
Reliance on Audits and information posted
Audits provided by the RCR or its members or fellows and other materials or content posted on AuditLive (together ‘Audits’) are based upon audits provided to the RCR by professionals in the field of radiology and the RCR cannot verify such Audits. Where any part of any Audit is based upon an opinion, you should be aware that other professionals in the field may have a different opinion. There are also continuous advances in medical practice. When using any Audit you must, therefore, consider such Audit in light of other professional guidance and medical advances. Accordingly you must make your own independent judgement in respect of the course of action that you take regarding your practice or patients as any action that you take in respect of your practice or patients is your responsibility and not the responsibility of the RCR.
It is solely your responsibility to evaluate the accuracy, completeness and usefulness of all Audits provided through AuditLive.
In using AuditLive you shall comply with all your duties as a doctor and, without limiting those duties, if you become aware of anything relating to AuditLive which would infringe or be contrary to your duty as a doctor, you will advise us immediately by email to [insert email address].
Our liability
Audits are provided without any guarantees, conditions or warranties (express or implied) as to their accuracy, quality, efficacy, completeness or fitness for a particular purpose. To the fullest extent permitted by law, the RCR shall not be liable to you whether in contract, tort (including but not limited to negligence), under statute or otherwise arising out of or in connection with any Information and the RCR accepts no liability for any inaccuracy or error in any of the Audits and is making no promises in respect of any results that may occur as a result of you relying on any of the Audits.
Nothing in these terms of use affects or restricts the RCR’s liability for death or personal injury caused to you by the RCR’s negligence, nor the RCR’s liability for fraudulent misrepresentation, nor any other liability which cannot be excluded or limited under applicable law.
Without prejudice to any other provision of these terms of use, you agree that the RCR shall have no liability to you in respect of any loss, liability or damage that you suffer as a result of or in connection with the death or personal injury of any person in respect of which you have relied upon any of the Audits provided in AuditLive whether such death or personal injury was caused by the RCR’s negligence or not.
Without prejudice to the provisions of the clauses above, in the unlikely event that the RCR is found to incur any liability in respect of any of the Audits, the total liability of the RCR in respect of any such Audit for any loss, liability or damage, howsoever caused, whether in contract, tort (including but not limited to negligence), under statute or in any other circumstances will be limited to the amount of monies receivable from the RCR’s insurers in respect of such loss, liability or damage (if any).
Contributing to AuditLive
Whenever you make a submission to AuditLive, you must comply with our Terms and Conditions for Submissions (‘terms’). You warrant that any such submission does comply with those terms, and you indemnify the RCR against all costs and losses that it incurs as a result of any breach of that warranty.
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The English courts will have exclusive jurisdiction over any claim arising from, or related to, AuditLive although we retain the right to bring proceedings against you for breach of these conditions in your country of residence or any other relevant country.
These terms of use and any dispute or claim arising out of or in connection with them or their subject matter or formation (including non-contractual disputes or claims) shall be governed by and construed in accordance with the law of England and Wales.
Variations
The RCR may revise these terms of use at any time by amending this page. You are expected to check this page from time to time to take notice of any changes made, as they are binding on you. Some of the provisions contained in these terms of use may also be superseded by provisions or notices published elsewhere on the RCR website.
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