Peripheral lung cancer: screening and detection with low-dose spiral CT versus radiography.

TLDR

The study compares low‑dose spiral CT with chest radiography for screening small peripheral lung cancers in high‑risk individuals and calls for larger trials to assess efficacy and cost‑effectiveness. Posteroanterior and lateral chest radiographs and low‑dose spiral CT scans were performed twice yearly from September 1993 to April 1995 on 1,369 high‑risk participants (3,457 examinations), with CT parameters of 120 kVp, 50 mA, 10‑mm collimation, and a 2:1 pitch. Low‑dose spiral CT detected 15 peripheral lung cancers (0.43%) versus 4 detected by radiography, with 73% of cancers missed by radiography and 93% being stage I, showing CT’s superiority over radiography.

Abstract

PURPOSE: To compare low-dose spiral computed tomography (CT) with radiography of the chest for the screening and detection of small peripheral lung cancers in a high-risk population. MATERIALS AND METHODS: Posteroanterior and lateral radiographs and low-dose spiral CT scans were obtained twice a year from September 1993 to April 1995 in 1,369 individuals (a total of 3,457 examinations) who were at high risk for lung cancer. Low-dose spiral CT parameters were 120 kvP, 50 mA, 10-mm collimation, and 2:1 pitch. RESULTS: Peripheral lung cancer was detected in 15 of 3,457 examinations (0.3%). Among the 15 cases, the results of chest radiography were negative in 11 (73%), and the tumors were detected only at low-dose spiral CT. The detection rates of low-dose spiral CT and chest radiography were 0.43% (15 of 3,457 examinations), respectively. Fourteen (93%) of the 15 (exclusion of one pulmonary lung cancer) tumors were stage I. CONCLUSION: Low-dose spiral CT was superior to chest radiography in the screening and detection of peripheral lung cancer in high-risk individuals. Further large-scale studies are warranted, however, to clarify the efficacy and cost-effectiveness of low-dose spiral CT in a randomized, controlled population.