Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
Ampronix

Low-Dose CT Screening Study Reveals Improved Diagnostic Performance for Lung Cancer

By Medimaging International staff writers
Posted on 09 Jul 2014
Print article
Image: A computed tomography (CT) scan showing lung cancer (Photo courtesy of Kevin Kavanagh, MD).
Image: A computed tomography (CT) scan showing lung cancer (Photo courtesy of Kevin Kavanagh, MD).
Investigators of a new study demonstrated good compliance and patient survival outcomes using a five-year low-dose computed tomography (LDCT) screening protocol in individuals at high-risk of developing lung cancer.

This COSMOS (Continuous Observation of SMOking Subjects) study protocol had fewer patients requiring additional diagnostic follow-up compared to other studies, including the US National Lung Cancer Screening Trial (NLST), with a minimal number of incorrect diagnoses.

The five-year survival rate for early diagnosed lung cancer is 50% but after the cancer has spread to distant regions it is only 4%. Recently, the NLST revealed a 20% lung cancer mortality reduction with LDCT compared to chest X-ray, which verified that early detection can decrease lung cancer deaths. However, few studies have comprehensively assessed the diagnostic performance, invasiveness and side effects of LDCT screening protocols with enduring follow-up.

The COSMOS study screened 5,203 asymptomatic high-risk subjects (age ≥ 50 and ≥ 20 pack years smoking history) who, based on the study criteria, either went on to other diagnostic procedures (CT, positron emission tomography [PET], or surgery) to verify lung cancer, or were rescreened every year for the next four years. All subjects were clinically followed for a median of 5.2 years.

The study’s findings, reported in the July 2014, issue of the Journal of Thoracic Oncology (JTO), the official journal of the International Association for the Study of Lung Cancer, show that overall, 79% of the participants remained on the study for five years and only 6.4% required a procedure beyond the yearly LDCT. Primary lung cancer was diagnosed in 175 patients and 78% of these were diagnosed with localized disease. Because of the size and long follow-up, there were 23,116 person-years of observation. Therefore, the overall lung cancer detection rate was 0.76 per 100 person-years.

Out of the 204 invasive diagnostic procedures, 29 were benign for lung cancer, 34 had minor complications, 12 major complications and one postoperative fatality was reported. There were 14 instances where the lesions were not diagnosed as cancer, but were later determined to be cancer on subsequent yearly screening. A high proportion of the cancers (87%) were treated with intent to cure and the overall five-year survival was 78%.

“The results of the COSMOS workup protocol for indeterminate nodules detected with LDCT screening are encouraging, particularly the low recall and delayed diagnosis rates as well as the good long-term survival,” said Dr. Giulia Veronesi, Dr. Giulia Veronesi from the department of thoracic surgery, European Institute of Oncology (Milan, Italy) is a member of the International Association for the Study of Lung Cancer (IASLC), and lead author of the study. “However, the workup can still be improved, possibly by tailoring the screening interval to the risk of the individual being screened using a risk evaluation algorithm that will hopefully also include in the near future molecular markers like a microRNA expression signature in serum.”

Related Links:

European Institute of Oncology



Print article
Radcal

Channels

MRI

view channel
Image: The results of MRI scans are expected to inform future clinical guidelines for heart disease (Photo courtesy of the University of Leeds).

MRI Helps Identify High-Risk Heart Disease Patients

A new study concludes that magnetic resonance imaging (MRI) scans are the safest and most effective way to identify patients with suspected coronary heart disease (CHD). Researchers at the University... Read more

Nuclear medicine

view channel
Image: The images demonstrate that Ga-68 DOTATATE PET/CT anterior 3D MIP and axial fused images could visualize metastases and change the surgical plan for resection (Photo courtesy of Ronald C. Walker, MD / Journal of Nuclear Medicine).

Study Shows Safety and Efficacy of Imaging Technique for Neuroendocrine Tumors

The results of a new study have demonstrated the safety and efficacy of Ga-68 DOTATATE PET/CT scans, compared to In-111 pentetreotide scans, the current US imaging standard for the detection Neuroendocrine... Read more

General/Advanced Imaging

view channel
Image: Emory radiologists reduce Phantom Limb Pain (PLP) by applying a new non-invasive cryoablation procedure (Photo courtesy of Kevin Makowski, RBP).

Radiologists Demonstrate Minimally Invasive Procedure that can Freeze Phantom Limb Pain

Researchers have presented the results of a study investing the use of cryoablation to reduce Phantom Limb Pain (PLP) in patients with chronic pain in amputated limbs. The researchers showed that interventional... Read more

Imaging IT

view channel

Latest Release of Enterprise Imaging Platform Demonstrated at ACR 2016

A global enterprise diagnostic imaging and advanced visualization solutions provider has demonstrated the latest release of their Enterprise Imaging Platform that features thin-client, server-side processing, and simple diagnostic mobile access. The manufacturer made the announcement at the annual meeting of the American... Read more

Industry News

view channel

UK Health Service to Spend GBP 21.5 Million Upgrading Radiotherapy Resources

The UK’s National Health Service has agreed to acquire linear accelerators, and software from a human care company in a deal valued at GBP 21.5 million. The order includes linear accelerators (linacs), multileaf collimators, and a system for improving the speed and reducing the radiation dose of radiation therapy treatment.... Read more
Copyright © 2000-2016 Globetech Media. All rights reserved.