The radiologist’s role in lung cancer screening

Abstract

Lung cancer is still the deadliest cancer in men and women worldwide. This high mortality is related to diagnosis in advanced stages, when curative treatment is no longer an option. Large randomized controlled trials have shown that lung cancer screening (LCS) with low-dose computed tomography (CT) can detect lung cancers at earlier stages and reduce lung cancer-specific mortality. The recent publication of the significant reduction of cancer-related mortality by 26% in the Dutch-Belgian NELSON LCS trial has increased the likelihood that implementation of LCS in Europe will move forward. Radiologists are important stakeholders in numerous aspects of the LCS pathway. Their role goes beyond nodule detection and nodule management. Being part of a multidisciplinary team, radiologists are key players in numerous aspects of implementation of a high quality LCS program. In this non-systematic review we discuss the multifaceted role of radiologists in LCS.

Prospective Multisite Cohort Study to Evaluate Shared Decision-Making Utilization Among Individuals Screened for Lung Cancer

“…Given the central role of SDM in individual screening decisions, efforts are necessary to ensure that SDM is not only occurring but occurring in a manner that is effective and informative. In this regard, radiologists can play a key role in providing education [26,27]. For example, Rosenkrantz et al [28] reported that subspecialty radiologist-led education sessions for the lay public incorporating simple language and representative images increased participants' knowledge and awareness regarding imaging-based screening tests, including LCS [28].…”

“…For example, Rosenkrantz et al [28] reported that subspecialty radiologist-led education sessions for the lay public incorporating simple language and representative images increased participants' knowledge and awareness regarding imaging-based screening tests, including LCS [28]. Given radiologists' expertise in LDCT interpretation, lung neoplasm detection, and screening-related risks such as radiation, they have a significant opportunity to help provide education before LCS and help in strategies for improving individuals' understanding of LCS results [26,27].…”

Diagnostic Value of Combined High-resolution Computed Tomography and Artificial Intelligence-Aided Diagnosis System in Prediction of Benign and Malignant Pulmonary Ground-Glass Nodules

“…Most previous studies have primarily examined the CT features of adenocarcinoma-predominant GGNs, primarily the lung-tumor interface, lobulation, spiculation, vacuole sign, air bronchogram sign, vascular convergence sign, pleural indentation sign, and interlobular septal obstruction sign (21,22). In addition to the above features, this study also showed that the interlobular septal obstruction sign was one of the important CT features distinguishing benign GGNs from malignant GGNs.…”

Current Evidence for a Lung Cancer Screening Program

“…Following the release of USPTF recommendations, an analysis done in the USA, estimated that scaling up lung cancer screening would increase imaging procedures by an average of 4% across Health Service Areas [66]. Optimization of resources could be achievable with reduction of lung cancer screening intensity, setting intervals of more than 1 year in cases with minor CT findings in which the risk is low, and who represent a large proportion of the screening population [67]. Artificial intelligence algorithms will be necessary to relief pressure on radiologists and radiology services and will play a role in different tasks of the screening process.…”