[Screening for lung cancer with low-dose spiral CT: results in 150 asymptomatic subjects].
OBJECTIVE
Our aim is to present initial baseline data from a screening trial on low-dose spiral computed tomography (CT). We describe enrollment criteria and a diagnostic algorithm based on initial low-dose CT findings.


METHODS
From September 2000 to May 2001, 150 asymptomatic smokers (age range 40-78 years; mean 55 years) were studied using non-enhanced low-dose spiral CT of the chest. Repeated short-term high resolution CT follow-up was performed for non-calcified pulmonary nodules smaller than 10 mm in diameter. Non-calcified pulmonary nodules 10 mm or larger were considered as potentially malignant and a complementary positron emission tomography (PET) exam was recommended.


RESULTS
54 non-calcified pulmonary nodules were found in 34 out of 141 (24.15%) symptom-free subjects. The diameter was 5 mm or shorter in 24 participants (70.6%), 6-10 mm in 7 (20.6%) and longer than 10 mm in 3 (8.8%) individuals. One patient with a non-calcified pulmonary nodule of at least 10 mm underwent a complementary PET exam, which was positive. Biopsy of this nodule demonstrated lung cancer (squamous cell carcinoma). CT follow-up over one year was decided in the other two subjects having non-calcified pulmonary nodules longer than 10 mm, as no radiographic signs indicative of malignancy were observed in the baseline scan.


CONCLUSIONS
Following this low-dose CT based screening programme, detection of early-stage lung cancer in asymptomatic subjects at high risk of developing the disease is feasible. Further studies are however necessary to pursue more definitive results.
Bastarrika
Gorka
G
Servicio de Radiología. Clínica Universitaria. Facultad de Medicina. Universidad de Navarra. Pamplona. Spain. bastarrika@unav.es
Pueyo
Jesús C
JC
Lozano
María Dolores
MD
Montuenga
Luis
L
Zulueta
Javier J
JJ
D000328:Adult; D000368:Aged; D002283:Carcinoma, Bronchogenic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies; D011829:Radiation Dosage; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D036542:Tomography, Spiral Computed