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Low-Dose CT Shows Promise For Asbestos Lung Screening

June 26, 2014
Written by: , Filed in: Chest Radiology, Medical Ethics, Practice Management
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A new algorithm greatly reduces radiation exposure from chest CT scans, making it a good choice for screening people who have been exposed to asbestos … except for a possible problem with what researchers called the “unusual appearance” of the images.

Chest CT is often used for lung cancer screening of asbestos-exposed subjects. But it exposes patients to higher radiation doses than a chest X-ray, and it often picks up incidental abnormalities that turn out to be benign but require follow-up scans.

So researchers in France experimented with the new Veo algorithm, which offers a significantly reduced radiation dosage compared to the gold standard filtered back projection (FBP) reconstruction but with less image noise than other low-dose algorithms. At University Hospital CHU G. Montpied in Clermont-Ferrand, France, researchers compared successive FBP and Veo scans for 27 asbestos-exposed workers. They published their findings online May 30 in the open-access BMJ Open.

Veo reduced radiation dosage dramatically—by 87 percent, the researchers calculated. It compared favorably with FBP in detecting most—but not all—potential asbestos-related problems. However, the BMJ Open article says, “The assessment of image quality showed discordant results.” The researchers said that although Veo “significantly reduced the level of objective noise,” the two radiologists who read the images reported increased subjective noise.

Perhaps, the article suggested, it may be a matter of getting used to the look of Veo:

This discordance may be explained by the novel appearance of Veo images requiring adaptation time for the radiologists.

At any rate, the results seem promising. Alex Strauss, managing editor of the website Surviving Mesothelioma, said in a news release that the technique offered hope for those at risk of that rare but especially deadly form of cancer: “Although we know that asbestos work dramatically raises mesothelioma risk, there is still no safe way to effectively monitor exposed workers. If this new technology is proven to make CT scanning safer, it could be lifesaving for many people.”

The researchers cautioned that “these results should be confirmed on a larger sample size before the use of Veo in clinical routine practice in asbestos-related conditions.”

Related CME seminar (up to 12 AMA PRA Category 1 credits™): UCSF Cardiovascular & Pulmonary Imaging

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