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Outside the Lab Clinical care, Microscopy and imaging, Oncology, Profession

The Integration Equation

At a Glance

  • Diagnostic workups can be complex and require the input of multiple medical specialists
  • To optimize diagnostic processes and use of samples, pathologists and radiologists should work together
  • When there are issues with a patient’s biopsy, a pathologist’s first port of call should be the radiologist
  • Our role as members of the health care team is evolving – and by working closely with our colleagues, we stay relevant and can be most helpful for our patients

When a patient is diagnosed with a lesion requiring further investigation, the diagnostic workup is frequently complex. It typically involves interaction between the initial clinician (usually a primary care physician), a specialist, one or more radiologists, and often several laboratory physicians, not to mention numerous support staff, nurses, physician assistants and laboratory technicians. In the setting of a teaching hospital, the environment can become even more complex as trainees in all of the involved departments are brought in as well.

With a straightforward case – for example, a 4.5 cm spiculated lung mass discovered on screening chest CT scan, subsequently biopsied, and found to be adenocarcinoma – the issues may seem trivial; however, correlating the various ancillary imaging and laboratory studies may prove challenging, potentially leading to diagnostic delays or misinterpretations. The need to assemble all forms of imaging and laboratory information can be tedious and exhausting when the results are reported in different systems or under several different tabs in the electronic medical record (EMR).

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About the Authors

W. Dean Wallace

Professor of Pathology and Laboratory Medicine and Chief of Pulmonary and Renal Pathology at the David Geffen School of Medicine, University of California, Los Angeles, USA.


Robert Suh

Professor of Radiological Sciences, Director of Thoracic Interventional Services, and Vice Chair of Radiology Education at the David Geffen School of Medicine, University of California, Los Angeles, USA.

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