scholarly journals Lung cancer screening by single-shot dual-energy subtraction using flat-panel detector

2021 ◽  
Author(s):  
Hiroshi Mogami ◽  
Yumiko Onoike ◽  
Hiroshi Miyano ◽  
Kenji Arakawa ◽  
Hiromi Inoue ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
Dual Energy ◽  
Single Shot ◽  
Flat Panel ◽  
Lung Cancers ◽  
Flat Panel Detector ◽  
Energy Subtraction ◽  
Resectable Cancer

Abstract Purpose The purpose of this study was to evaluate the usefulness of single-shot dual-energy subtraction (DES) method using a flat-panel detector for lung cancer screening Materials and methods The subjects were 13,315 residents (5801 males and 7514 females) aged 50 years or older (50–97 years, with an intermediate value of 68 years) who underwent lung cancer screening for a period of 1 year and 6 months from January 2019 to June 2020. We investigated whether the number of lung cancers detected, the detection rate, and the rate of required scrutiny changed, when DES images were added to the judgment based on conventional chest radiography. Results When DES images were added, the number and percentage of cancer detection increased from 16 (0.12%) to 23 (0.17%) (P < 0.05). Five of the newly detected 7 lung cancers were in the early stages of resectable cancer. The rate of participants requiring scrutiny increased slightly from 1.1 to 1.3%. Conclusion DES method improved the detection of lung cancer in screening. The increase in the percentage of participants requiring scrutiny was negligible.

scholarly journals Mobile Low-Dose Computed Tomographic (LDCT) Scanning combined with Remote Reading: a feasible approach to lung cancer screening among rural population

2021 ◽  
Author(s):  
Bojiang Chen ◽  
Jun Shao ◽  
Jinghong Xian ◽  
Pengwei Ren ◽  
Wenxin Luo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Rural Areas ◽  
Pulmonary Nodules ◽  
Lung Cancer Screening ◽  
Western China ◽  
Control Group ◽  
Local Hospital ◽  
Lung Cancers ◽  
Computed Tomographic

Abstract BackgroundLow-dose computed tomographic (LDCT) screening has been proven to be powerful in detecting lung cancers in early stage. However, it’s hard to carry out in less-developed regions in lacking of facilities and professionals. The feasibility and efficacy of mobile LDCT scanning combined with remote reading by experienced radiologists from superior hospital for lung cancer screening in deprived areas was explored in this study.MethodsA prospective cohort was conducted in rural areas of western China. Residents over 40 years old were invited for lung cancer screening by mobile LDCT scanning combined with remote image reading or local hospital-based LDCT screening. Rates of positive pulmonary nodules and detected lung cancers in the baseline were compared between the two groups.ResultsAmong 8073 candidates with preliminary response, 7251 eligibilities were assigned to the mobile LDCT with remote reading (n = 4527) and local hospital-based LDCT screening (n = 2724) for lung cancer. Basic characteristics of the subjects were almost similar in the two cohorts except that the mean age of participants in mobile group was relatively older than control (61.18 vs. 59.84 years old, P < 0.001). 1778 participants with mobile LDCT scans with remote reading (39.3%) revealed 2570 pulmonary nodules or mass, and 352 subjects in the control group (13.0%) were detected 472 ones (P < 0.001). Proportions of nodules less than 8 mm or subsolid were both more frequent in the mobile LDCT group (83.3% vs. 76.1%, 32.9% vs. 29.8%, respectively; both P < 0.05). In the baseline screening, 26 cases of lung cancer were identified in the mobile LDCT scanning with remote reading cohort, with a lung cancer detection rate of 0.57% (26/4527), which was significantly higher than control (4/2724 = 0.15%, P = 0.006). Moreover, 80.8% (21/26) of lung cancer patients detected by mobile CT with remote reading were in stage I, remarkedly higher than that of 25.0% in control (1/4, P = 0.020).ConclusionMobile LDCT combined with remote reading is probably a potential mode for lung cancer screening in rural areas.Trial registrationNo. of registration trial was ChiCTR-DDD-15007586 (http://www.chictr.org).

scholarly journals Effectiveness of Lung Cancer Screening Implementation in the Community Setting in the United States

2019 ◽  
Vol 15 (7) ◽  
pp. e607-e615 ◽  
Author(s):  
Amy Copeland ◽  
Angela Criswell ◽  
Andrew Ciupek ◽  
Jennifer C. King
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Cancer Screening ◽  
Low Dose ◽  
Community Setting ◽  
Lung Cancer Screening ◽  
The United States ◽  
Community Based ◽  
Lung Cancers ◽  
Low Dose Computed Tomography

PURPOSE: The National Lung Screening Trial demonstrated a 20% relative reduction in lung cancer mortality with low-dose computed tomography screening, leading to implementation of lung cancer screening across the United States. The Centers for Medicare and Medicaid Services approved coverage, but questions remained about effectiveness of community-based screening. To assess screening implementation during the first full year of CMS coverage, we surveyed a nationwide network of lung cancer screening centers, comparing results from academic and nonacademic centers. METHODS: One hundred sixty-five lung cancer screening centers that have been designated Screening Centers of Excellence responded to a survey about their 2016 program data and practices. The survey included 21 pretested, closed- and open-ended quantitative and qualitative questions covering implementation, workflow, numbers of screening tests completed, and cancers diagnosed. RESULTS: Centers were predominantly community based (62%), with broad geographic distribution. In both community and academic centers, more than half of lung cancers were diagnosed at stage I or limited stage, demonstrating a clear stage shift compared with historical data. Lung-RADS results were also comparable. There are wide variations in the ways centers address Centers for Medicare and Medicaid Services requirements. The most significant barriers to screening implementation were insurance and billing issues, lack of provider referral, lack of patient awareness, and internal workflow challenges. CONCLUSION: These data validate that responsible screening can take place in a community setting and that lung cancers detected by low-dose computed tomography screening are often diagnosed at an early, more treatable stage. Lung cancer screening programs have developed different ways to address requirements, but many implementation challenges remain.

Effectiveness of mobile computerized tomographic (CT) lung scanning unit for early diagnosis of lung cancer in under-served populations.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6567-6567
Author(s):  
Derek Raghavan ◽  
Darcy L Doege ◽  
Mellisa S Wheeler ◽  
John D Doty ◽  
James Oliver ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Low Dose ◽  
Lung Cancer Screening ◽  
The United States ◽  
Lung Cancers ◽  
Low Dose Ct ◽  
Screening Unit ◽  
Lung Screening ◽  
Lung Scanning

6567 Background: The National Lung Screening Trial (NLST) demonstrated that screening high-risk patients with low-dose CT (LDCT) of the chest reduces lung cancer mortality compared to screening with chest x-ray. Uninsured and Medicaid patients lack access to this hospital-based screening test due to geographic isolation/socio-economic factors. We hypothesized that a mobile screening unit would improve access and confer benefits demonstrated by the NLST to this under-served group, which is most at risk of lung cancer deaths. Methods: In collaboration with Samsung Inc, we inserted a BodyTom portable 32 slide low-dose CT scanner into a 35-foot coach, reinforced to avoid equipment damage, to function as a mobile lung scanning unit. The unit includes a waiting area, high speed wireless internet connection for rapid image transfer, and electronic tablets to deliver smoking cessation and health education programs and shared decision-making video aids. It has been certified as a lung cancer screening Center of Excellence by Lung Cancer Alliance. We employed the LUNG RADS approach to lesion classification, yielding high sensitivity and specificity in assessment. All films were reviewed by a central panel of oncologists, pulmonologists and radiologists. The protocol was approved by Chesapeake IRB, which oversees all LCI cancer trials. Interim analysis at this time was approved by the Oversight Committee. Results: We screened 470 under-served smokers between 4/2017-1/2019; M:F 1.1:1, mean age 61 years (range 55-64), with average pack year history of 45.7 (30-150) (25% African-American; 3% Hispanic; 65% rural; 100% uninsured, under-insured or Medicaid - NC Medicaid does not cover lung cancer screening). Patients over the age of 64 years were excluded as they are covered by Medicare for lung cancer screening. We found at initial screen 35 subjects with LUNG RADS 4 lesions, 49 subjects with LUNG RADS 3 lesions, 10 lung cancers (2.1%), including 4 at stage I-II. 4 non-lung cancers were identified and treated. Other incidental non-oncologic findings are the subject of another presentation. Conclusions: In this small sample using the first mobile low dose CT lung screening unit in the United States, the initial cancer detection rate is comparable to that reported in the NLST but with marked improvement of screening rates in underserved groups and with better anticipated outcomes at lower cost than if they had first presented with metastatic disease.

scholarly journals Clinically detected non-aggressive lung cancers: implications for overdiagnosis and overtreatment in lung cancer screening

Thorax ◽  
2018 ◽  
Vol 73 (5) ◽  
pp. 407-408 ◽  
Author(s):  
Kevin ten Haaf ◽  
Carlijn M van der Aalst ◽  
Harry J de Koning
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
Lung Cancers

Performance of community-based lung cancer screening program in a region with a high rate of endemic histoplasmosis.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 58-58
Author(s):  
Shruti Bhandari ◽  
Prashant Gyanendra Tripathi ◽  
Christina M Pinkston ◽  
Goetz H. Kloecker
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Screening Program ◽  
False Positive Rate ◽  
Lung Cancer Screening ◽  
Adherence Rate ◽  
Lung Cancers ◽  
Cancer Screening Program ◽  
Positive Rate ◽  
Lung Cancer Screening Program

58 Background: Lung cancer screening (LCS) with Low dose computed-tomography (LDCT) has been recommended by USPSTF for high-risk population since 2013 largely based on 20% relative reduction in lung cancer mortality shown in National Lung Screening Trial (NLST). The success of NLST was related to its high adherence rate and thorough ascertainment of lung cancers and deaths. This study evaluated performance of lung cancer screening program in Histoplasmosis endemic community. Methods: Demographic and clinical information was collected through retrospective review on all patients in the lung cancer screening program of a Kentucky health system comprising 21 centers from 2016 and 2017. A positive LDCT screen is defined as Lung-RADS version 1.0 assessment categories 3 or 4. Results: A total of 4500 LDCT screens were performed in 2016 (39%) and 2017 (61%) with 49% adherence rate to repeat annual screen in 2017. Mean age of patients was 64 years, majority being females (54%) and current smokers (69%) with average 52-pack year smoking history. The rate of positive LDCT was 13.3% (600) varying based on initial (14.6%) vs annual (9.5%) screen. A total of 70 lung cancers were diagnosed among all positive LDCT screens (11.7%) with a false positive rate of 12%. Conclusions: Comparing to NLST results updated with Lung-RADS categories, baseline positive screens in our community are similar (14.6% vs 13.6%, p = 0.15) despite being a Histoplasmosis endemic region. Our higher rate of annual positive screens (9.5% vs 6%, p < 0.001) and false positive rate (12% vs 8%, p < 0.001) may be explained by poor adherence to annual screens and an inability to thoroughly ascertain lung cancer diagnosis in all patients due to lost to follow up. In community setting with < 50% adherence to annual screens compared to 95% adherence in NLST, it is unclear if LCS mortality benefit still holds and needs intervention to increase adherence to LCS.

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