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IMAGING & DIAGNOSTICS

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EBUS (Endobronchial Ultrasound):

Usually referred via the local Lung Cancer MDT following imaging showing mediastinal/hilar lymphadenopathy.

 

  • Weekly EBUS lists are held at most tertiary sites (e.g., GSTT, St George’s, PRUH, Woolwich)

  • Bookings typically coordinated via MDT coordinator or respiratory admin.

  • Include most recent CT thorax, PET scan (if available), and relevant clinical history.

 

Tip: Ensure anticoagulation plan is clear pre-procedure.

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PET-CT (Positron Emission Tomography):

Used for lung cancer staging, solitary nodule evaluation, or systemic sarcoidosis.

STH & EGH (use RMH)

King’s College Hospital & GSTT 

  • Typically requested following Lung Cancer MDT discussion.

  • Include recent CT, smoking history, and MDT outcome.

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CPET (Cardiopulmonary Exercise Testing):

Helps differentiate between cardiac, respiratory, deconditioning, and functional causes of

breathlessness.

  • For unexplained dyspnoea (after spirom HRCT, ECHO), pre-op assessment, PH (need baseline assessments first)

  •  Available at Royal Brompton and GSTT (limited availability).

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Pleural:

Referral is appropriate for patients with recurrent pleural effusions, suspected pleural malignancy, pneumothorax, or diagnostic uncertainty following initial aspiration or imaging. Services include diagnostic thoracoscopy, indwelling pleural catheter insertion, and management of complex effusions or trapped lung.

⚠️ Disclaimer

This guide is intended as a helpful reference for respiratory trainees rotating through South London hospitals.

While every effort has been made to ensure the information is accurate and up to date as of May 2025 and changes may occur and some content may become outdated or include errors.

Please confirm referral processes and contact details locally and always follow up referrals through appropriate channels. Clinical decisions should be guided by local protocols, discussion with colleagues, and consultant supervision. This guide is not a substitute for local trust guidelines or official policies. The authors cannot accept responsibility for any inaccuracies or outcomes resulting from the use of this document.

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