Dados do Trabalho

Título

Opportunistic screening of lung cancer in CT assessment of coronary artery disease

Descrição sucinta do(s) objetivo(s)

The objective is to determine the feasibility of incorporating an extra chest ultra-low-dose CT scan into the coronary CT angiography procedure for the purpose of lung cancer screening in patients who are considered to have coronary artery CT study

Material(is) e método(s)

A total of 2750 patients received coronary CT angiography to evaluate coronary artery disease or Calcium score assessment. In addition, they also underwent ultra-low-dose CT screening in the same scanner, using parameters of 80 kVp and 15-25 mAs, for the early detection of lung cancer. Patients with pulmonary nodules were monitored for a period of two years. During this time, low-dose CT scans were performed at intervals of 3, 6, or 12 months, depending on the size and growth rate of the nodules. These intervals were determined based on the criteria provided by the National Comprehensive Cancer Network.

Resultados e discussão

Ultra-low-dose CT detected 1045 patients with single pulmonary nodules, accounting for 38% of the total. These nodules had an average diameter of 4.57 ± 4.00 mm. Out of the total of 254 cases with a size more than 6 mm, it was shown that in 84% of these cases (n = 222), the findings were false positives. This result was further supported by additional tests (n = 158), surgical removal (n = 7), or tissue biopsy (n = 57). CT screening identified lung cancer in 32 patients, resulting in a diagnosis yield of 1.16%. Out of them, 12 cases were not identifiable within the cardiac field of view. 24 patients were in the early stages of the disease. The inclusion of the ultra-low-dose CT scan resulted in a radiation dose increase of 2.25 ± 0.43% (equivalent to an effective dose of 0.13 ± 0.03 mSv) in CT coronary angiography and in 9.9 +/-0.55% in calcium score studies.

Conclusões

The detection of lung cancer could potentially be achieved by the utilization of supplementary ultra-low- dose protocols in coronary CT angiography scans conducted on individuals who are considered to have CT coronary artery study.

Palavras Chave

lung cancer; CT coronary artery; CT angiography

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