Radiation Exposure to Low-Dose Computed Tomography for Lung Cancer Screening: Should We Be Concerned?
Abstract
:1. Introduction
2. The Problem of Radiation Exposure in Lung Cancer Screening
3. Radiation Dose Estimates in Lung Cancer Screening
3.1. Estimates of Single Low-Dose CT Round
3.2. Estimates of Cumulative Dose in Lung Cancer Screening
3.3. Estimates Based on Interval Screening
3.4. Estimates Based on Age at Start
3.5. Estimates Based on Gender
3.6. The Synergic Role of Radiations and Tobacco
4. Technical Approach of LDCT
5. Future Direction
5.1. Towards Individually Tailored Screening Programs
5.2. Technological Advances
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Acknowledgments
Conflicts of Interest
Abbreviations
4-IN-THE-LUNG-RUN | Towards INdividually tailored INvitations, screening INtervals and INtegrated co-morbidity reducing strategies in lung cancer screening |
ACR | American College of Radiology LC: Lung Cancer |
ALARA | As Low as Reasonably Achievable |
ASIR | Adaptive Statistical Iterative Reconstruction |
BEIR | Biologic Effects of Ionizing Radiation |
CAD | Computer-aided detection |
CTDIvol | Volume Computed Tomography Dose Index |
DANTE | Detection and Screening of Early Lung Cancer by Novel Imaging Technology and Molecular Essays |
DLIR | Deep Learning Iterative Reconstruction |
ED | Effective dose |
ESTI | European Society of Thoracic Imaging |
LCS | Lung Cancer Screening |
LDCT | Low-Dose Computed Tomography |
LNT | Linear No-Threshold |
MILD | Multicentric Italian Lung Detection |
MIP | Maximum intensity projection |
NELSON | Nederlands–Leuvens Longkanker Screenings Onderzoek |
NLST | National Lung Screening Trial |
P/Y | Pack/Years |
PCDCT | Photon-Counting Detectors Computer Tomography |
PET/CT | Positron Emission Tomography/Computed Tomography |
PLCOm2012 | Prostate, Lung, Colorectal, and Ovarian model |
USPSTF | United States Preventive Services Task Force |
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Trial | Age (y/o) | Smoking Status | n | Type of Study | Rounds and Follow-Up | Results |
---|---|---|---|---|---|---|
NLST | 55–75 | smokers >30 p/y; <15 years former smokers | 53,454 | LDCT vs. CXR | 3 annual rounds; 5.2 years | 20% reduced LC mortality compared to CXR (HR 0.8, p < 0.004) |
NELSON | 55–74 | >15 p/y; ≤10 years former smokers | 15,792 | LDCT observational | 4 rounds (1, 2, and 2.5 years after); 11 years | 24% and 33% reduced LC mortality in males and females, respectively (HR 0.76) |
DANTE | 60–74 | >20 p/y; <10 years former smoker | 2811 | LDCT observational | 4 annual rounds; 8 years | Non-significant reduction in LC mortality (HR 0.99) |
MILD | >49 | >20 p/y; <15 years former smoker | 4099 | LDCT observational | 8 years annual or biannual rounds; 10 years | Reduction of 10-year risk of LC mortality (HR 0.61) |
ITALUNG | 55–69 | >20 p/y; <10 years former smoker | 3206 | LDCT observational | 4 annual rounds; 10 years | Non-significant reduction in LC mortality (HR 0.7) |
DLCST | 50–70 | >20 p/y; <10 years former smoker | 4104 | LDCT vs. CXR | 5 annual rounds; 5 years | Non-significant reduction in LC mortality (HR 1.03) |
LUSI | 50–69 | >15 p/y; <10 years former smoker | 4052 | LDCT observational | 5 annual rounds; 8.8 years | Reduction in LC mortality in women (HR 0.31; p = 0.04) |
UKLS | 50–75 | N/A | 4055 | LDCT observational | 1 round; 7.3 years | Non-significant reduction in LC mortality (HR 0.65) |
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Pozzessere, C.; von Garnier, C.; Beigelman-Aubry, C. Radiation Exposure to Low-Dose Computed Tomography for Lung Cancer Screening: Should We Be Concerned? Tomography 2023, 9, 166-177. https://doi.org/10.3390/tomography9010015
Pozzessere C, von Garnier C, Beigelman-Aubry C. Radiation Exposure to Low-Dose Computed Tomography for Lung Cancer Screening: Should We Be Concerned? Tomography. 2023; 9(1):166-177. https://doi.org/10.3390/tomography9010015
Chicago/Turabian StylePozzessere, Chiara, Christophe von Garnier, and Catherine Beigelman-Aubry. 2023. "Radiation Exposure to Low-Dose Computed Tomography for Lung Cancer Screening: Should We Be Concerned?" Tomography 9, no. 1: 166-177. https://doi.org/10.3390/tomography9010015