Aims and objectives
Lung cancer is the most common cancer worldwide with 1.6 million deaths worldwide in 20121.
Several large American institutions have recommended lung cancer screening with low dose CT chest in specific population groups2,3,4.
If lung cancer screening was implemented in Scotland there would be a very large increase in requirement for chest CT scans.
These would all need reported,
increasing radiological workload and cost.
We postulated that combining the use of computer aided detection (CAD) and analysis could safely exclude lung cancer in a large...
Methods and materials
The initial screening Chest CT scans from Glasgow patients enrolled within the prospective ECLS study5 were sent for Lung-RADs analysis by Diagnostic Image Analysis Group Department of Radiology and Nuclear Medicine,
Radboud University Medical Center.
Computer aided detection was used to identify nodules and then categorise them into one of four groups (CAD 1 - 4) based upon probability of malignancy taking into account lesion morphology,
size,
location and texture.
Independently and blind to the CAD results the scans were reported by two experienced consultant...
Results
CAD categorisation had a statistically significant correlation with the radiologist categorisation (p<0.001).
None of the 113 (36%) patients within the CAD 1 group (no nodule identified) were found to have lung nodule(s).
Conclusion
CAD and risk stratification is useful in excluding lung cancer on thoracic CT within the screening population.
CAD followed by radiology review of suspicious cases is the cost effective and would lead to a 30% reduction in screening costs.
References
Fact Sheets by Cancer (2017) Globocan.iarc.fr.
Available at: http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx (Accessed: 26 April 2017).
Jaklitsch MT,
Jacobson FL,
Austin JH.
The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups.
Journal of Thoracic and Cardiovascular Surgery 2012;144(1):33–38.
DOI: 10.1016/j.jtcvs.2012.05.060.
Smith RA,
Andrews K,
Brooks D,
DeSantis CE,
Fedewa SA,
Lortet-Tieulent J,
et al.
Cancer screening in the United States,
2016: A review of current American Cancer Society guidelines and current issues in...