Feature | Radiology Imaging | June 30, 2015

Annual Low-Dose CT Screening Safe and Reliable for Identifying Pre-Cancers

Mount Sinai study suggests two-year intervals could improve detection while reducing unnecessary imaging exams

lung cancer, low dose CT screening, nodules, cancerous, Icahn, Mount Sinai

June 30, 2015 - An annual exam using a key imaging technology could spare patients with lung nodules from unnecessary tests and surgery, while identifying the cases where the nodules are likely to become cancerous, according to a new study. Researchers at Icahn School of Medicine at Mount Sinai (ISMMS) published the study online in the journal Radiology.

The study authors found the imaging technology, called low-dose computed tomography (LDCT), to be a safe and effective screening tool to monitor those with nonsolid lung nodules, which in some cases are precursors to cancer. Lung nodules are small tissue masses in the lungs that can be benign or cancerous. They are classified as solid, part solid or nonsolid, based on their appearance on CT, which combines a series of X-ray images taken from different angles and uses computer processing to create cross-sectional images, or slices, of the bones, blood vessels and soft tissues of the body. Nonsolid nodules have become a common finding on CT scans of the chest, and management of them is challenging.

"Nonsolid nodules are caused by inflammation, infection or fibrosis, and in some cases indicate cancer risk," said study co-author Claudia I. Henschke, Ph.D., M.D., clinical professor of radiology, ISMMS. "Our goal is to identify the nodules that require closer investigation and those that do not."

In the new study, Henschke and colleagues analyzed results from 57,496 participants in the International Early Lung Cancer Program (I-ELCAP), a worldwide initiative focused on reducing deaths from lung cancer. The participants underwent baseline and annual repeat screenings, to which the researchers evaluated the prevalence of nonsolid nodules and their effect on long-term outcomes.

In the study, 2,392 baseline LDCT screenings, or 4.2 percent, identified a nonsolid nodule and further analysis of this group led to the diagnosis of 73 cases of cancer. Annual repeat screenings identified a new nonsolid nodule in 485 participants, or 0.7 percent, of which 11 were diagnosed with Stage I cancer. The nonsolid nodule developed a solid component-a warning sign of invasive cancer-in 22 cases prior to treatment.

However, the median transition time from nonsolid to part-solid was more than two years. This suggests that nonsolid nodules of any size can be safely followed with CT at 12-month intervals to assess a potential transition to part-solid. One immediate benefit of the study findings may be a reduction in the overtreatment of nodules, according to study co-author David Yankelevitz, M.D., professor of radiology, Icahn School of Medicine at Mount Sinai.

"Our study shows the importance of annual screening and follow-up in the general population," said Yankelevitz. "This could further reduce unnecessary CT scans, possible biopsies or even surgery for lung cancer."

The study results also provide additional information to help in the shared decision making process between physicians and patients, Yankelevitz said.

"Patients can be assured that annual screening intervals are sufficient," he added. "This is a major step forward for lung cancer screening protocols."

For more information: www.icahn.mssm.edu

Related Content

3-D Reconstruction of Ichthyosaurus Skull

A 3-D reconstruction of the ichthyosaurus skull from a computed tomography (CT) scan. Image courtesy of Nigel Larkin, taken at Royal Veterinary College, London.

News | Computed Tomography (CT) | January 09, 2019
A nearly meter-long skull of a giant fossil marine ichthyosaur found in a farmer's field more than 60 years ago has...
SCCT Releases New Guideline for CT Use During TAVR
News | Computed Tomography (CT) | January 08, 2019
The Society of Cardiovascular Computed Tomography (SCCT) has released a new expert consensus document for computed...
Artificial Intelligence Pinpoints Nine Different Abnormalities in Head Scans

A brain scan (left) showing an intraparenchymal hemorrhage in left frontal region and a scan (right) of a subarachnoid hemorrhage in the left parietal region. Both conditions were accurately detected by the Qure.ai tool. Image courtesy of Nature Medicine.

News | Artificial Intelligence | January 07, 2019
The rise in the use of computed tomography (CT) scans in U.S. emergency rooms has been a well-documented trend1 in...
CT Technique Expands Possibilities of Imaging Ancient Remains
News | Computed Tomography (CT) | December 27, 2018
Researchers in Sweden using computed tomography (CT) have successfully imaged the soft tissue of an ancient Egyptian...
Canon Aquilion One CT Helps Gates Vascular Institute Adhere to New Stroke Guidelines
News | Computed Tomography (CT) | December 12, 2018
In stroke, time saved on imaging is time gained in the treatment window. The recently updated guidelines from the...
Coreline Soft Introduces AI Lung Segmentation Solution at RSNA 2018
News | Lung Cancer | December 10, 2018
December 10, 2018 — Korean image software company Coreline Soft Co. Ltd.
FDA Approves New Features for Planmed Verity Cone Beam CT Scanner
Technology | Computed Tomography (CT) | December 07, 2018
The U.S. Food and Drug Administration (FDA) issued an approval letter for the new features and intended uses of the...
YITU Releases AI-Based Cancer Screening Solutions at RSNA 2018
News | Artificial Intelligence | December 06, 2018
Chinese artificial intelligence (AI) healthcare company YITU healthcare released two brand-new products, Intelligent...
Guerbet Launches Multi-Use OptiVantage Contrast Media Injector in Europe
Technology | Contrast Media Injectors | December 05, 2018
Contrast agent company Guerbet recently announced that the OptiVantage multi-use contrast media injector is now CE...
GE Healthcare Unveils New Applications and Smart Devices Built on Edison Platform
Technology | Artificial Intelligence | December 05, 2018
GE Healthcare recently announced new applications and smart devices built on Edison – a platform that helps accelerate...