Digital Chest Tomosynthesis Provides Alternative to CT Lung Cancer Screening

A recent study concluded that digital chest tomosynthesis has value as a first-line lung cancer screening tool.

Most lung tumors are identified when patients become symptomatic and have late-stage disease. However, recently, computed tomography (CT) screening for lung cancer has been reported to reduce lung cancer mortality. Because the US National Lung Screening Trial’s findings revealed a 20% reduction in lung cancer-specific deaths in those patients who had screening performed with chest CT, the use of CT screening for lung cancer has been gaining favor. However, CT is associated with the disadvantages of high radiation dosage and cost.

The study’s findings were published May 30, 2013, in the Journal of Thoracic Oncology (JTO). DT uses a conventional radiograph tube, a flat-panel detector, a computer-controlled tube mover, and special reconstruction algorithms to produce section images. Compared with standard chest radiography, chest tomosynthesis improved sensitivity in the identification of CT-validated lung nodules. While it does not have the depth resolution of CT, tomosynthesis provides some of the benefits of CT at lower costs and radiation dosages. Furthermore, DT is less expensive than CT at approximately one-sixths of the cost of a CT.

Researchers from the thoracic surgery unit and department of radiology at the S. Croce City Hospital (Cuneo, Italy) assessed 1919 patients. Participants were aged 45 to 75 with a smoking history of at least 20-pack years, without malignancy in the five years before the start of the study in December 2010. A tomosynthesis was performed at baseline and one year later. The researchers concluded that, “the results on the use of DT in early detection of lung cancer are encouraging; the detection rate is comparable to the rates reported for low-dosage CT and is attained at a far lower cost and radiation dosage.”

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S. Croce City Hospital