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Vol.40 No.2 contents | Japanese/English |
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- Original Article -
A Pilot Study of Lung Cancer Screening with Low-Dose Spiral CT
Akinobu Yoshimura1, Masahiro Andoh1, Shoji Kudoh1, Jun Watari2, Hiroyuki Tajima2, Tatsuhiko Kumasaki2, Mitsuomi Matsumoto3, Tsuyoshi Yano4, Tadaaki Miyamoto5, Toru Matsumoto51Fourth Department of Internal Medicine, Nippon Medical School, 2Department of Radiology, Nippon Medical School, 3Tokyo Metropolitan University of Health Sciences, 4Arakawaku City Cancer Prevention Center, 5National Institute of Radiological Sciences
Objective: We performed a pilot study to evaluate the efficacy of lung cancer screening with low-dose spiral CT (CT screening) from June to December 1996. Methods: Volunteers from participants in conventional lung cancer screening with computed radiography and sputum cytological assessment (CR screening) in the same period were enrolled into this study. CT scans of the chest were made in a single breath-hold with low-dose spiral CT for lung-cancer screening. Results: Overall 431 individuals (22.9%) out of 1,880 participants were judged to need further examinations by either conventional or CT screening. Two hundred and ninety eight individuals (15.9%) of them were classified as "e" judgement which means possible or probable lung cancer by CT screening. Then 418 individuals had further examinations. Eight cases were diagnosed as having lung cancer (detection rate: 0.43%), of whom only two cases were detected by CR screening. Therefore, the positive predictive value in CT screening was 0.027. All cases had adenocarcinomas, located in peripheral lung regions. The mean diameter of tumors was 17 mm (range 8-25 mm) and three small cancers less than 10 mm were detected. There were 5 stageIA cases, 1 stageIB case, 1 stageIIIA case and 1 stageIV case. Six patients with stageIA or IB disease underwent surgical treatment. Conclusions: It was suggested that low-dose spiral CT was superior in the detection of peripheral lung cancer and is a promising tool in lung cancer screening. It is necessary to establish a system of annual CT screening and the method of comparative reading of CT scan in order to improve the positive predictive value of CT screening.
key words: Lung cancer screening, Low-dose spiral CT, Early detection, Small lung cancer, Positive predictive value
Received: October 4, 1999
Accepted: February 14, 2000
JJLC 40 (2): 99-105, 2000
