Low-dose CT: technique, reading methods and image interpretation

Abstract

The National Lung Cancer Screening Trial has recently demonstrated that screening of high-risk populations with the use of low-dose computed tomography (LDCT) reduces lung cancer mortality[1]. Based on this encouraging result, the National Comprehensive Cancer Network guidelines recommended LDCT for selected patients at high risk of lung cancer[2]. This suggests that an increasing number of CT screening examinations will be performed. The LDCT technique is relatively simple but some CT parameters are important and should be accurately defined in order to achieve good diagnostic quality and minimize the delivered dose. In addition, LDCT examinations are not as easy to read as they may initially appear; different approaches and tools are available for nodule detection and measurement. Moreover, the management of positive results can be a complex process and can differ significantly from routine clinical practice. Therefore this paper deals with the LDCT technique, reading methods and interpretation in lung cancer screening, particularly for those radiologists who have little experience of the technique.

Lung Cancer Screening, Version 1.2015

“…79 Because slice thickness, reconstruction algorithms, and postprocessing filters affect nodule size measurement, the same technical parameters should be used for each screening LDCT (eg, the same window/width and window/level settings). 109,110 Some organizations, including the ACR, recommend using CT dose tracking for all CT screening programs to ensure that screening facilities adhere to acceptable low-dose radiation limits (eg, reporting the dose-length product and/or CT dose index for each CT). 111…”

Lung cancer screening: Computed tomography or chest radiographs?

“…Various strategies such as reduced tube voltage, tube current, or both is being used. The application of iterative reconstruction would maintain spatial resolution in low dose studies whilst maintain diagnostic accuracy [40] . Overall, it is highly likely that low-dose CT screening for patients at high risk for developing lung cancer is a cost-effective approach which will lead to improved outcome due to earlier detection and treatment of this highly lethal malignancy.…”

The Case for Lung Cancer Screening: What Nurses Need to Know

“…These include appropriate-grade CT scanners with specialized software to enhance interpretation, physicists to ensure safety with radiation exposure, trained radiology staff, guidelines for the management of positive findings, and a plan for care coordination for follow-up and communication with the primary care physicians ordering the scans (NCCN, 2016). Quality control for the interpretation of scans, well-trained radiologists, and a multidisciplinary approach for the management of positive findings are critical to lung cancer screening programs (Rampinelli, Origgi, & Bellomi, 2013).…”