Lung cancer screening with low-dose chest computed tomography: recent radiologic advances

Abstract

Lung cancer is the leading cause of cancer-related death worldwide. Most patients are diagnosed with advanced disease, resulting in a poor prognosis. Screening may induce the early detection of lung cancer and early detection of lung cancer may reduce lung cancer-related mortality. Recently, the National Lung Screening Trial has demonstrated that lung cancer screening with low-dose chest computed tomography (LDCT) showed a 20% reduction in lung cancer-related mortality and a 6.7% decrease in all-cause mortality in the US. Based on the results of National Lung Screening Trial, various lung cancer-related societies recommend lung cancer screening using LDCT in asymptomatic populations at high risk based on old age and a heavy smoking history. For effective and responsible lung cancer screening, LDCT should be performed at sites providing high-quality low-radiation exposure computed tomography (CT). LDCT must be performed with multidetector helical CT in a single breath-hold and use adequate technical parameters. CT is interpreted accurately by qualified physicians. And structured reporting and management system should be recommended for high quality reporting and medical outcomes monitoring. Adverse events associated with LDCT screening may include a high detection rate of lung nodules and high false positive results, overdiagnosis, and relatively high radiation exposure. However, lung cancer screening with LDCT can result in more benefits than harms when performed in settings with high quality screening programs.