Usefulness of low-dose spiral CT of the chest in regular follow-up of postoperative non-small cell lung cancer patients: Preliminary report.
OBJECTIVE
There is no consensus for the best postoperative follow-up in patients after complete resection of non-small cell lung cancer. Low-dose computed tomography of chest proves valuable in screening primary lung cancer and may be a useful tool in postoperative surveillance.


METHODS
In part 1, 30 patients who underwent surgical resection of non-small cell lung cancer and were at the first (n = 14), second (n = 9), or fifth (n = 7) annual postoperative surveillance were selected chronologically and subjected to chest radiography, low-dose computed tomography, and standard-dose computed tomography to verify the diagnostic accuracy of low-dose computed tomography. In part 2, 43 patients were prospectively enrolled and followed up regularly after complete resection of non-small cell lung cancer. The follow-up protocol included physical examination, sputum cytology, serum carcinoembryonic antigen, chest radiography, and low-dose computed tomography every 3 months in the first 2 years postoperatively until tumor recurrence.


RESULTS
In part 1, tumor recurrence was detected by standard-dose computed tomography in 7 cases. Low-dose computed tomography and chest radiography missed 1 and 5 of 7 cases, respectively. In part 2, tumor recurrence was found in 14 cases with 19 metastatic sites. Thirteen of the 14 (92.9%) cases were detected by scheduled visiting and 11 (78.6%) detected by low-dose computed tomography including the 7 without symptoms. Of the 19 recurrent sites found in 14 patients, 11 ones (57.9%) were detected by low-dose computed tomography.


CONCLUSIONS
Low-dose computed tomography may be of considerable value in early detection of tumor recurrence in postoperative non-small cell lung cancer patients. Further large prospective studies are needed to verify this issue.
Chiu
Chao-Hua
CH
Chest Department, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China.
Chern
Ming-Sheng
MS
Wu
Mei-Han
MH
Hsu
Wen-Hu
WH
Wu
Yu-Chung
YC
Huang
Min-Hsiung
MH
Chang
Shi-Chuan
SC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D011013:Pneumonectomy; D011446:Prospective Studies; D013902:Radiography, Thoracic; D036542:Tomography, Spiral Computed