Improving Utilization of Low Dose CT Protocols For Lung Cancer Screening
Main Article Content
Keywords
lung cancer screening, low-dose CT, radiation dose, protocols
Abstract
Lung cancer is the leading cause of cancer deaths worldwide. Low-dose computed tomography (LDCT) screening has been shown to reduce lung cancer mortality in high-risk individuals. However, utilization of LDCT screening remains low due to concerns regarding radiation exposure, cost-effectiveness and overdiagnosis. radiologists play an important role in guiding screening protocols and ensuring diagnostic accuracy while minimising radiation dose. This paper reviews evidence on LDCT protocols for lung cancer screening and proposes strategies to optimise screening within our healthcare system.
References
Aberle, D. R., Adams, A. M., Berg, C. D., Black, W. C., Clapp, J. D., Fagerstrom, R. M., ... & Sicks, J. D. (2011). Reduced lung-cancer mortality with low-dose computed tomographic screening. New England Journal of Medicine, 365(5), 395-409.
American College of Radiology (2014). Lung CT screening reporting & data system (Lung-RADS). Reston, VA: American College of Radiology.
American College of Radiology (2017). Lung cancer screening center designation program requirements. Reston, VA: American College of Radiology.
Bach, P. B., Mirkin, J. N., Oliver, T. K., Azzoli, C. G., Berry, D. A., Brawley, O. W., Byers, T., ... & Detterbeck, F. C. (2012). Benefits and harms of CT screening for lung cancer: a systematic review. JAMA, 307(22), 2418-2429.
Black, W. C., Gareen, I. F., Soneji, S. S., Sicks, J. D., Keeler, E. B., Aberle, D. R., ... & Gatsonis, C. (2014). Cost-effectiveness of CT screening in the National Lung Screening Trial. New England Journal of Medicine, 371(19), 1793-1802.
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians, 68(6), 394-424.
Centers for Medicare and Medicaid Services (2015). Decision memo for screening for lung cancer with low dose computed tomography (LDCT) (CAG-00439N). Baltimore, MD: Centers for Medicare and Medicaid Services.
Choo, J. Y., Goo, J. M., Lee, C. H., Park, C. M., Park, S. J., & Shim, M. S. (2014). Optimal pitch and iteration for lung cancer screening: simulation study of ultra-low-dose CT. Korean journal of radiology, 15(6), 754.
Christe, A., Leidolt, L., Huber, A., Steiger, P., Szucs-Farkas, Z., Roos, J. E., & Heverhagen, J. T. (2013). Lung cancer screening with CT: evaluation of radiologists and different computer assisted detection software (CAD) as first and second readers for lung nodule detection at different dose levels. European journal of radiology, 82(10), e973-e978.
De Koning, H. J., Van Der Aalst, C. M., De Jong, P. A., Scholten, E. T., Nackaerts, K., Heuvelmans, M. A., ... & Ten Haaf, K. (2020). Reduced lung-cancer mortality with volume CT screening in a randomized trial. New England Journal of Medicine, 382(6), 503-513.
De Marco, K., & Origgi, D. (2018). Current status of low-dose CT lung cancer screening. La radiologia medica, 123(1), 1-7.
Goo, J. M., & Gierada, D. S. (2014). State-of-the-art low-dose CT of the lung. European Journal of Radiology, 83(8), 1308-1317.
Howlader, N., Forjaz, G., Mooradian, M.J., Meza, R., Kong, C.Y., Cronin, K.A., Mariotto, A.B., Lowy, D.R. & Feuer, E.J. (2019). The effect of advances in lung-cancer treatment on population mortality. New England Journal of Medicine, 380(7), 640-649.
Huo, J., Volk, R. J., Shih, Y. T., Ford, E. W., Spencer, K., & Wolf, R. L. (2017). Use of CT and chest radiography for lung cancer screening before and after publication of screening guidelines: intended and unintended uptake. JAMA internal medicine, 177(3), 439-441.
Jemal, A., & Fedewa, S. A. (2017). Lung cancer screening with low-dose computed tomography in the United States-2010 to 2015. JAMA oncology, 3(9), 1278-1281.
Kazerooni EA, Armstrong MR, Amorosa JK, Hernandez D, Liebscher LA, Nath H, Mcnutt RA, Stern EJ, Wilcox PA. (2017). ACR CT accreditation program and the lung cancer screening program designation. Journal of the American College of Radiology, 14(2), 285-289.
McMahon PM, Meza R, Plevritis SK, Black WC, Tammemägi M, Erdogan A, Fulton R, Obadan NO, Koff D, Woloshin S. (2017). Comparing benefits from many possible computed tomography lung cancer screening programs: extrapolating from the National Lung Screening Trial using comparative modeling. PLoS One, 12(6), e0179979.
Moyer VA. (2014). Screening for lung cancer: US Preventive Services Task Force recommendation statement. Annals of Internal Medicine, 160(5), 330-338.
Pedersen, J. H., Ashraf, H., Dirksen, A., Bach, K., Hansen, H., Toennesen, P., ... & Mortensen, J. (2009). The Danish randomized lung cancer CT screening trial–overall design and results of the prevalence round. Journal of Thoracic Oncology, 4(5), 608-614.
Pham, D., Bhandari, S., Oechsli, M., Pinkston, C. M., & Kloecker, G. H. (2018). Lung cancer screening rates: data from the lung cancer screening registry. Journal of Clinical Oncology, 36(15_suppl), 6504-6504.
Pinsky, P. F., Gierada, D. S., Black, W., Jeon, J., Nath, H., Aberle, D., & Bach, P. B. (2015). Performance of lung-RADS in the National Lung Screening Trial: a retrospective assessment. Annals of internal medicine, 162(7), 485-491.
Pinsky, P. F., Gierada, D. S., Nath, P. H., Kazerooni, E. A., & Amorosa, J. (2014). National Lung Screening Trial: variability in nodule detection rates in chest CT studies. Radiology, 273(3), 886-892.
Singh, S., Pinsky, P., Fineberg, N. S., Gierada, D. S., Garg, K., Li, Q., ... & Mehta, A. C. (2014). Evaluation of reader variability in the interpretation of follow-up CT scans at lung cancer screening. Radiology, 273(1), 270-278.
Society of Thoracic Radiology (2017). STR practice parameter for the performance and reporting of lung cancer screening thoracic computed tomography (CT). Reston, VA: Society of Thoracic Radiology.
Tammemägi, M. C., Katki, H. A., Hocking, W. G., Church, T. R., Caporaso, N., Kvale, P. A., ... & Riley, T. L. (2013). Selection criteria for lung-cancer screening. New England Journal of Medicine, 368(8), 728-736.
Villanti, A. C., Jiang, Y., Abrams, D. B., & Pyenson, B. S. (2017). A cost-utility analysis of lung cancer screening and the additional benefits of incorporating smoking cessation interventions. PloS one, 12(8), e0183902.
Wender, R., Fontham, E. T. H., Barrera Jr, E., Colditz, G. A., Church, T. R., Ettinger, D. S., ... & Smith, R. A. (2013). American Cancer Society lung cancer screening guidelines. CA: a cancer journal for clinicians, 63(2), 107-117.
Wiener, R. S., Gould, M. K., Woloshin, S., Schwartz, L. M., & Clark, J. A. (2018). “The thing is not knowing”: patients' perspectives on surveillance of an indeterminate pulmonary nodule. Health Expectations, 21(1), 355-365.
Wood, D. E., Eapen, G. A., Ettinger, D. S., Hou, L., Jackman, D., Kazerooni, E., ... & Vachani, A. (2012). Lung cancer screening. Journal of the National Comprehensive Cancer Network, 10(2), 240-265.
Yankelevitz, D. F., Yip, R., Smith, J. P., Liang, M., Liu, Y., Xu, D. M., ... & Henschke, C. I. (2014). CT screening for lung cancer: nonsolid nodules in baseline and annual repeat rounds. Radiology, 273(2), 576-584.
American College of Radiology (2014). Lung CT screening reporting & data system (Lung-RADS). Reston, VA: American College of Radiology.
American College of Radiology (2017). Lung cancer screening center designation program requirements. Reston, VA: American College of Radiology.
Bach, P. B., Mirkin, J. N., Oliver, T. K., Azzoli, C. G., Berry, D. A., Brawley, O. W., Byers, T., ... & Detterbeck, F. C. (2012). Benefits and harms of CT screening for lung cancer: a systematic review. JAMA, 307(22), 2418-2429.
Black, W. C., Gareen, I. F., Soneji, S. S., Sicks, J. D., Keeler, E. B., Aberle, D. R., ... & Gatsonis, C. (2014). Cost-effectiveness of CT screening in the National Lung Screening Trial. New England Journal of Medicine, 371(19), 1793-1802.
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians, 68(6), 394-424.
Centers for Medicare and Medicaid Services (2015). Decision memo for screening for lung cancer with low dose computed tomography (LDCT) (CAG-00439N). Baltimore, MD: Centers for Medicare and Medicaid Services.
Choo, J. Y., Goo, J. M., Lee, C. H., Park, C. M., Park, S. J., & Shim, M. S. (2014). Optimal pitch and iteration for lung cancer screening: simulation study of ultra-low-dose CT. Korean journal of radiology, 15(6), 754.
Christe, A., Leidolt, L., Huber, A., Steiger, P., Szucs-Farkas, Z., Roos, J. E., & Heverhagen, J. T. (2013). Lung cancer screening with CT: evaluation of radiologists and different computer assisted detection software (CAD) as first and second readers for lung nodule detection at different dose levels. European journal of radiology, 82(10), e973-e978.
De Koning, H. J., Van Der Aalst, C. M., De Jong, P. A., Scholten, E. T., Nackaerts, K., Heuvelmans, M. A., ... & Ten Haaf, K. (2020). Reduced lung-cancer mortality with volume CT screening in a randomized trial. New England Journal of Medicine, 382(6), 503-513.
De Marco, K., & Origgi, D. (2018). Current status of low-dose CT lung cancer screening. La radiologia medica, 123(1), 1-7.
Goo, J. M., & Gierada, D. S. (2014). State-of-the-art low-dose CT of the lung. European Journal of Radiology, 83(8), 1308-1317.
Howlader, N., Forjaz, G., Mooradian, M.J., Meza, R., Kong, C.Y., Cronin, K.A., Mariotto, A.B., Lowy, D.R. & Feuer, E.J. (2019). The effect of advances in lung-cancer treatment on population mortality. New England Journal of Medicine, 380(7), 640-649.
Huo, J., Volk, R. J., Shih, Y. T., Ford, E. W., Spencer, K., & Wolf, R. L. (2017). Use of CT and chest radiography for lung cancer screening before and after publication of screening guidelines: intended and unintended uptake. JAMA internal medicine, 177(3), 439-441.
Jemal, A., & Fedewa, S. A. (2017). Lung cancer screening with low-dose computed tomography in the United States-2010 to 2015. JAMA oncology, 3(9), 1278-1281.
Kazerooni EA, Armstrong MR, Amorosa JK, Hernandez D, Liebscher LA, Nath H, Mcnutt RA, Stern EJ, Wilcox PA. (2017). ACR CT accreditation program and the lung cancer screening program designation. Journal of the American College of Radiology, 14(2), 285-289.
McMahon PM, Meza R, Plevritis SK, Black WC, Tammemägi M, Erdogan A, Fulton R, Obadan NO, Koff D, Woloshin S. (2017). Comparing benefits from many possible computed tomography lung cancer screening programs: extrapolating from the National Lung Screening Trial using comparative modeling. PLoS One, 12(6), e0179979.
Moyer VA. (2014). Screening for lung cancer: US Preventive Services Task Force recommendation statement. Annals of Internal Medicine, 160(5), 330-338.
Pedersen, J. H., Ashraf, H., Dirksen, A., Bach, K., Hansen, H., Toennesen, P., ... & Mortensen, J. (2009). The Danish randomized lung cancer CT screening trial–overall design and results of the prevalence round. Journal of Thoracic Oncology, 4(5), 608-614.
Pham, D., Bhandari, S., Oechsli, M., Pinkston, C. M., & Kloecker, G. H. (2018). Lung cancer screening rates: data from the lung cancer screening registry. Journal of Clinical Oncology, 36(15_suppl), 6504-6504.
Pinsky, P. F., Gierada, D. S., Black, W., Jeon, J., Nath, H., Aberle, D., & Bach, P. B. (2015). Performance of lung-RADS in the National Lung Screening Trial: a retrospective assessment. Annals of internal medicine, 162(7), 485-491.
Pinsky, P. F., Gierada, D. S., Nath, P. H., Kazerooni, E. A., & Amorosa, J. (2014). National Lung Screening Trial: variability in nodule detection rates in chest CT studies. Radiology, 273(3), 886-892.
Singh, S., Pinsky, P., Fineberg, N. S., Gierada, D. S., Garg, K., Li, Q., ... & Mehta, A. C. (2014). Evaluation of reader variability in the interpretation of follow-up CT scans at lung cancer screening. Radiology, 273(1), 270-278.
Society of Thoracic Radiology (2017). STR practice parameter for the performance and reporting of lung cancer screening thoracic computed tomography (CT). Reston, VA: Society of Thoracic Radiology.
Tammemägi, M. C., Katki, H. A., Hocking, W. G., Church, T. R., Caporaso, N., Kvale, P. A., ... & Riley, T. L. (2013). Selection criteria for lung-cancer screening. New England Journal of Medicine, 368(8), 728-736.
Villanti, A. C., Jiang, Y., Abrams, D. B., & Pyenson, B. S. (2017). A cost-utility analysis of lung cancer screening and the additional benefits of incorporating smoking cessation interventions. PloS one, 12(8), e0183902.
Wender, R., Fontham, E. T. H., Barrera Jr, E., Colditz, G. A., Church, T. R., Ettinger, D. S., ... & Smith, R. A. (2013). American Cancer Society lung cancer screening guidelines. CA: a cancer journal for clinicians, 63(2), 107-117.
Wiener, R. S., Gould, M. K., Woloshin, S., Schwartz, L. M., & Clark, J. A. (2018). “The thing is not knowing”: patients' perspectives on surveillance of an indeterminate pulmonary nodule. Health Expectations, 21(1), 355-365.
Wood, D. E., Eapen, G. A., Ettinger, D. S., Hou, L., Jackman, D., Kazerooni, E., ... & Vachani, A. (2012). Lung cancer screening. Journal of the National Comprehensive Cancer Network, 10(2), 240-265.
Yankelevitz, D. F., Yip, R., Smith, J. P., Liang, M., Liu, Y., Xu, D. M., ... & Henschke, C. I. (2014). CT screening for lung cancer: nonsolid nodules in baseline and annual repeat rounds. Radiology, 273(2), 576-584.
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Published
Apr 19, 2022
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How to Cite
Abdullah Ibrahem Alhussain, Abdullah Ahmed Alghamdi, Khalid Mohammed Alfahad, Zaid Abdullah Alshalhoub, Nasser Yahya Aljubran, Faiez Amer Albeeshi, & Abdullah Ibrahem Alhussain, Abdullah Ahmed Alghamdi, Khalid Mohammed Alfahad, Zaid Abdullah Alshalhoub, Nasser Yahya Aljubran, Faiez Amer Albeeshi. (2022). Improving Utilization of Low Dose CT Protocols For Lung Cancer Screening. Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 929-937. https://doi.org/10.53555/jptcp.v29i04.5627
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Abdullah Ibrahem Alhussain, Abdullah Ahmed Alghamdi, Khalid Mohammed Alfahad, Zaid Abdullah Alshalhoub, Nasser Yahya Aljubran, Faiez Amer Albeeshi, & Abdullah Ibrahem Alhussain, Abdullah Ahmed Alghamdi, Khalid Mohammed Alfahad, Zaid Abdullah Alshalhoub, Nasser Yahya Aljubran, Faiez Amer Albeeshi. (2022). Improving Utilization of Low Dose CT Protocols For Lung Cancer Screening. Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 929-937. https://doi.org/10.53555/jptcp.v29i04.5627