OET Case Notes: Radiography — Chest CT Findings Report (Intermediate)
A radiographer reports CT chest findings to a referring respiratory consultant for a 62-year-old ex-smoker with an incidental 12 mm solitary pulmonary nodule. The intermediate challenge: translating technical imaging findings into concise clinical language, selecting what matters for the consultant's decision, and framing a recommendation without exceeding the radiographer's clinical scope.
Letter type
Referral
Write to
Referring Consultant (Respiratory Physician)
Target length
200–230 words
The case notes
Patient: Mr David Morrison, 62 years old
Reason for CT: Incidental 12 mm pulmonary nodule on chest X-ray during pre-operative assessment
Scan performed: CT thorax with contrast (2 mm slice thickness)
Right upper lobe: 12 × 10 mm soft tissue nodule, well-defined margins, non-calcified, no satellite nodules; Fleischner category CT-2
Hilar/mediastinal nodes: No pathological lymphadenopathy
Lung parenchyma: Background centrilobular emphysema bilaterally, consistent with smoking history; no consolidation, pleural effusion, or pneumothorax
Clinical history: Ex-smoker (30 pack-years, quit 8 years ago); no haemoptysis, weight loss, or systemic symptoms
Impression: Indeterminate 12 mm RUL nodule; malignancy cannot be excluded; surveillance recommended
Writing task
Write a report letter to referring consultant Dr Claire Nguyen summarising the CT chest findings, your impression, and your recommendation for follow-up.
What to include, what to cut
The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.
Include
The nodule's size, location, and key characteristics (margins, calcification)
These are the decision-relevant imaging features. The consultant needs them to classify risk and plan follow-up. Size without location or margin detail is incomplete.
The Fleischner category and recommended follow-up interval
Using the Fleischner classification frames the recommendation within an evidence-based guideline, which is expected in a radiography report letter.
The background emphysema with reference to the smoking history
Incidental findings relevant to the clinical background must be included. Emphysema in a 30-pack-year ex-smoker is clinically significant and contextualises nodule risk.
Leave out
Technical imaging parameters beyond slice thickness (kV, mA, dose report)
These belong in the technical record, not the clinical letter. The consultant needs findings and recommendations, not radiation physics.
Listing all normal structures
Mention normal structures only if the clinical question required their exclusion. Listing everything normal pads the letter without adding clinical value.
Criterion in focus · Conciseness & Clarity
Radiology report letters are among the most concise in clinical correspondence. The examiner penalises redundancy: '12 × 10 mm well-defined non-calcified nodule' carries the same information as a much longer description in 40% of the words. Every adjective must earn its place. If removing it would not change the consultant's decision, cut it.
Now write the letter — and find out what is blocking your Grade B
Write a 200–230 words referral letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $15.