Timely Lung Cancer Intervention Through Interdisciplinary Collaboration: The Role of Radiology Nurses in a Single-Center Pulmonary Nodule Program

Background Early detection of pulmonary nodules was essential to lung cancer outcomes, but the benefit of imaging depended on reliable communication, documented follow-up plans, and timely referral when nodules were clinically actionable. Purpose The purpose was to demonstrate how a collaborative radiology–pulmonary nodule clinic used radiology quality assurance (QA)–registered nurses and incidental findings coordinator (IFC)–registered nurses to identify newly reported pulmonary nodules, initiate referral pathways, support patient navigation, and facilitate communication among providers. Method At a tertiary and quaternary academic medical center in Orange County, California, radiology QA-registered nurses screened computed tomography reports for new pulmonary nodules of at least 7 mm in diameter. Eligible cases were routed to primary care or ordering clinicians for referral to the pulmonary nodule clinic. IFC-registered nurses supported closed-loop communication, patient education, and timely scheduling. Results Over 3 years, 2,096 patients were referred for pulmonary nodule evaluation, and 285 (14%) underwent biopsy. Pathology showed metastatic disease in 98 (34%), primary non–small cell lung carcinoma in 86 (30%), benign nodules in 86 (30%), infectious nodules in 14 (5%), and primary small cell carcinoma in one (0.4%). Conclusions The nurse-led, radiology-integrated workflow created a standardized closed-loop pathway for patients with incidentally detected pulmonary nodules. This model clarified clinical accountability, supported follow-up care, and provided a scalable framework for health systems seeking to strengthen lung nodule management programs.