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Trial Backs CT For Lung Cancer Screening, If …

January 3, 2011
Written by: , Filed in: Chest Radiology
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CT works well as a lung-cancer screening tool for high-risk populations, but only if done with a strict clinical protocol in place and with input from a multidisciplinary care team, according to University of Cincinnati researchers.

The Cincinnati area presents a particular challenge because of its high rate of the fungal infection histoplasmosis—three times the national average. Histoplasmosis increases the likelihood of lung nodules, which can resemble lung cancer on CT scans and lead to unnecessary biopsies.

“Despite having a 60 percent nodule rate, we were able to avoid doing benign biopsies and not miss any lung cancer diagnoses if the protocol was strictly followed,” said Sandra Starnes, MD, director of thoracic surgery at the University of Cincinnati College of Medicine. “No one was diagnosed at a stage where the lung tumor could not be surgically removed.”

Dr. Starnes, who is also a surgeon with the university-affiliated UC Health, was quoted in a university news release. The study’s findings are scheduled to be reported soon online in advance of print publication in the Journal of Thoracic and Cardiovascular Surgery.

Dr. Starnes and her team recruited 132 heavy smokers older than 50. They underwent annual low-dose CT screening scans for five years.

“The Ohio River Valley’s high prevalence of histoplasmosis makes lung cancer screening very challenging because so many nodules show up on the imaging studies,” she said. “By using three-dimensional CT imaging, we are able to look more closely at the anatomical structure of these nodules and identify concerning lesions.”

Other recent studies have also supported CT scans as a screening tool for lung cancer among populations of long-term heavy smokers—high-risk populations. However, Dr. Starnes said that if it becomes standard practice, CT screening needs to rigorously follow a defined protocol and include input from a multidisciplinary team.

“If lung cancer screenings are not offered in a scientifically valid and regimented way,” she said, “people will end up getting unnecessary testing and biopsies for benign disease. That is why the collective knowledge of an experienced multidisciplinary team is so critical.” The multidisciplinary thoracic cancer team at UC Health consists of radiologists, pulmonologists, medical oncologists, radiation oncologists, pathologists, gastroenterologists, respiratory therapists, experienced oncology nurses, and fellowship-trained surgeons.

Related seminar: Thoracic Imaging

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