News | May 08, 2013

Minimal Dose CT Superior to Chest X-Ray for Detection of Recurrent Lung Cancer

Greater sensitivity, with lower radiation dose, allows for faster treatment, reported at 93rd AATS Annual Meeting

Minimal dose CT, chest X-Ray

Lung cancer is associated with very high mortality, in part because it is hard to detect at early stages, but also because it can recur frequently after surgical removal. The question arises as to what is the best way to follow lung cancer patients after surgery in order to spot problems early enough, before symptoms become obvious, so that patients may still be eligible for new interventions. In this study presented at the 93rd AATS Annual Meeting, investigators from the University of Toronto departments of Thoracic Surgery and Diagnostic Radiology show that minimal dose computed tomography (MnDCT) of the thorax offers much greater sensitivity at detecting new or recurrent lung cancer, with equivalent amount of radiation, compared to conventional chest X-rays.

"Up to a few years ago, we were using chest x-rays to monitor patients after surgery for lung cancer, but this follow-up was ineffective, and many patients still died of recurrent lung cancer, comments lead investigator Waël C. Hanna, MDCM, MBA, of the Department of Thoracic Surgery at the University of Toronto. "While CT scans can effectively be used to monitor lung cancer after surgery, there was significant concern about the large amount of radiation that will be delivered to patients, and standard dose CT scans were not used routinely in the follow-up of lung cancer. More recently, new technology allowed us to develop MnDCT."

As reported in this study, the majority of new or recurrent cancer was detected by MnDCT at a subclinical, intrathoracic stage, within two years of surgery. This allowed for the delivery of curative treatment in the majority of patients with asymptomatic cancer and was associated with long survival.

The study followed 271 patients with lung cancer (80 percent Stage I, 12.5 percent Stage II) who underwent curative resection of lung cancer. Repeated imaging occurred at 3, 6, 12, 18, 24, 36, 48 and 60 months using both standard chest x-rays and MnDCT.

Investigators found that MnDCT detected 94% of recurrent cancers compared to only 21% with standard X-rays (p<0.0001). Importantly, the recurrent lung cancer was detected at a much earlier stage, allowing patients to possibly undergo another curative surgery.

Detection of a new or recurrent cancer in asymptomatic patients led to further surgery or radiation for 75.5 percent, while palliative treatment was recommended for the remainder of patients. Survival in the treated group was significantly longer than those who were treated with palliative intent (69 months vs. 15 months, p<0.0001).

"MnDCT offers the best of both worlds: on the one hand it allows for precise imaging close to what is produced from a standard CT scan, and on the other hand it only delivers a small amount of radiation which is comparable to what a regular X-ray would deliver and much less than a standard dose CT scan," says Hanna. "More importantly, now we can detect recurrent lung cancer at a much earlier stage, allowing patients to possibly undergo another surgery, and live longer, healthier lives."

The study did find that MnDCT results produced a high rate of false positives, and the need for surgeons to be alert to this limitation in order to make correct clinical judgments regarding follow-up treatment.

 

Related Content

Houston Methodist Hospital Enters Multi-Year Technology and Research Agreement With Siemens Healthineers
News | Imaging | August 17, 2017
Houston Methodist Hospital and Siemens Healthineers have entered into a multi-year agreement to bring cutting-edge...
Four Blue Cross Blue Shield Companies Issue Positive Medical Policies on HeartFlow FFRct Analysis
News | Computed Tomography (CT) | August 09, 2017
HeartFlow Inc. announced that four Blue Cross Blue Shield companies have each issued a positive medical policy for the...
MRI Reveals Striking Brain Differences in People with Genetic Autism

Example images for a control participant , a deletion carrier, and a duplication carrier. In the sagittal image of the deletion carrier, the thick corpus callosum, dens and craniocervical abnormality, and cerebellar ectopia are shown. For the duplication carrier, the sagittal image shows the thin corpus callosum and the axial image shows the increased ventricle size and decreased white matter volume. Image courtesy of the Radiological Society of North America (RSNA).

News | Neuro Imaging | August 09, 2017
August 9, 2017 — In the first major study of its kind, researchers using magnetic...
Clinical Data Supports Use of Xoft System for Endometrial Cancer
News | Brachytherapy Systems | August 03, 2017
Researchers presented clinical data supporting use of the Xoft Axxent Electronic Brachytherapy (eBx) System for the...
brain with chronic traumatic injury
News | Magnetic Resonance Imaging (MRI) | August 02, 2017
Fighters are exposed to repeated mild traumatic brain injury (mTBI), which has been associated with neurodegenerative...
The American Lung Association created LUNG FORCE, a national movement to defeat lung cancer
News | Lung Cancer | August 02, 2017
To raise public awareness of lung cancer—the leading cancer killer of men and women—the American Lung Association's...
GE’s DoseWatch is a digital informatics solution that automatically collects, monitors and reports on radiation dose indices for diagnostic imaging exams
News | Radiation Dose Management | July 31, 2017
GE Healthcare announced that it has licensed computed tomography (CT) organ dosimetry technology developed at Duke...
NIH-funded scientists have discovered that Parkinson’s disease increases the amount of “free” water in a particular brain area

NIH-funded scientists have discovered that Parkinson’s disease increases the amount of “free” water in a particular brain area. Image courtesy of David Vaillancourt, Ph.D., University of Florida.

News | Neuro Imaging | July 31, 2017
Scientists at the University of Florida have discovered a new method of observing the brain changes caused by Parkinson...
more healthcare providers and patients are choosing options such as Gamma Knife stereotactic radiosurgery
News | Radiation Therapy | July 31, 2017
Each year, up to 650,000 people who were previously diagnosed with various forms of cancer will develop brain...
Contrast Media from Bayer, trends in contrast media and developments in contrast media
Feature | Contrast Media | July 28, 2017 | By Dave Fornell
Here are several updates in medical imaging ...
Overlay Init