Expert-led educational courses on Interstitial Lung Disease (ILD) and Incidental Pulmonary Nodules (IPN) are now available on the CAR member portal.

These innovative online courses were created for and by CAR members, drawing on the expertise of the Canadian Society of Thoracic Radiology (CSTR), an Affiliate Society of the CAR.

ILD Courses

The ILD educational content consists of two Section 2 courses – a real-time review of ILD pathologies with voice-over commentary and a masterclass consisting of 12 didactic lectures – and one Section 3 course with a repository of 30 scrollable, unannotated cases including 11 different ILD pathologies to deepen the learner’s appreciation for the slight variation in imaging features associated with different ILD injury patterns.

The purpose of creating the courses, said CSTR President Dr. Cameron Hague, was to provide an online resource for training and practicing radiologists to turn to for review and assist with everyday practice.

“We wanted to help radiologists with understanding and interpreting HRCTs using a variety of different methods and with real-life case examples from the Canadian Registry for Pulmonary Fibrosis (CARE-PF), a Canadian based ILD registry which is one of the largest in the world, with Multidisciplinary Discussion (MDD) as the gold standard for diagnosis.”

Dr. Hague says the didactic lessons provide background for the various ILDs and act as a framework for understanding this complex field. The lessons are up to date and apply the most recent guidelines and terminology for ILD interpretation. 

As with any major educational project, putting together the learning material was a massive undertaking that required the work of many hands.

“This was a team effort,” said Dr. Hague, “with the lectures and voice-over recordings provided by some of Canada’s leading ILD radiologists.”

The CAR was extremely grateful to receive unrestricted education grants from Boehringer Ingelheim to support the development of these learning activities.

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IPN Courses

The IPN project involved assembling three components that are all Section 3 accredited:

• Activity 1: Choosing Wisely Recommendations. The Working Group in collaboration with the Canadian Thoracic Society developed a series of recommendations for IPN.  
• Activity 2: IPN Microlessons. A series of seven online lessons were created with the aim of strengthening the interpretation and management of IPN.
• Activity 3: IPN Webinars. Two IPN webinars and briefing notes were presented to primary care providers (Dr. Paula Patino) and Radiology Directors (Dr. Daria Manos) in an effort to provide guidance and to highlight the role non-radiologists play in ensuring safe IPN management.

“With recent improvements in CT sensitivity and increases in diagnostic CT use, the detection of IPNs has become more frequent,” said Dr. Manos, Thoracic Radiologist at Dalhousie University and member of the CSTR Executive. “While most IPN are benign, an important minority represent early asymptomatic lung cancer. Radiologists and other health care providers must balance the importance of cancer detection with the need to protect patients from the harm of invasive diagnostic assessment and from the unnecessary radiation of repeat or advanced imaging.”

The online course is delivered as a series of micro lessons that can be taken individually or all together, which Dr. Manos points out is a novel approach to CPD.

“These are short presentations that address specific concerns, like ‘is this nodule an ignorable-perifissural opacity?’ and ‘do I need to follow this endobronchial opacity?’. These can be viewed at any time, but we also thought people could refer to them as needed when reporting cases.”

Dr. Manos says that each activity represented an immense undertaking with excellent coordination from CAR staff and participation from external partners.

“The Choosing Wisely Canada recommendations were constructed using a Delphi process. In addition to voting, we had engaging discussions. I don’t think I’ve even been involved in something where meeting attendance was 100% every time.”

The CAR was extremely grateful to receive unrestricted education grants from AstraZeneca to support the development of these learning activities.