Keywords:
Retrospective, Dilatation, Chronic obstructive airways disease, Aneurysms, Cost-effectiveness, Computer Applications-Detection, diagnosis, CT, Thorax, Oncology, Artificial Intelligence, Chest, Case-control study, Performed at one institution
Authors:
A. Nikolaev, I. Blokhin, V. Gombolevskiy, P. Gelezhe, V. Chernina, S. Morozov, A. Laipan; Moscow/RU
DOI:
10.26044/ecr2020/C-11091
Purpose
Lung cancer is the most common cause of cancer mortality in the world [1]. Moscow Lung Cancer Screening project was launched in Moscow since 2017, aimed at the selective screening of lung cancer in an outpatient population through the use of ultra-low-dose computed tomography (ultra-LDCT).
It should be noted that several similar screening projects are currently being carried out in the world, which has proved their importance in increasing early detection and reducing mortality [2].
Along with lung nodules, according to the ultra-LDCT, it is possible to identify other clinically significant findings (for example, emphysema or coronary arteries calcification), which radiologists should adequately interpret in order to choose the right patient management [3].
The National Lung Cancer Screening Trial (NLST) program revealed clinically significant incidental findings in 10.2% of those examined at the baseline without signs of lung cancer [4,5].
In Canadian lung cancer screening study with LDCT, 19% of the subjects revealed incidental findings, while 0.8% of them were clinically significant and required immediate further routing of the patient [6]. The attitude to incidental findings is twofold.
On the one hand, analysis of the results of the Nederlands-Leuvens Longkanker Screenings Onderzoek screening program (NELSON) showed that coronary calcium is a predictor of cardiovascular events and increases the risk of death in lung cancer risk group. On the other hand, the identification of incidental findings requires additional examination of the patient, which increases the cost of medical care, but is not always justified, and also increases the risk of harm from subsequent medical procedures [7].
Objective: to assess the significance of random findings detected during selective lung cancer screening with ultra-LDCT in Moscow.
Fig. 1: Localization of incidental findings in Moscow Lung Cancer Screening