title: Asbestos Surveillance Program Aachen (ASPA): initial results from baseline screening for lung cancer in asbestos-exposed high-risk individuals using low-dose multidetector-row CT.
abstract: The purpose of this study was to assess the prevalence of lung cancer in a high-risk asbestos-exposed cohort using low-dose MDCT. Of a population of 5,389 former power-plant workers, 316 were characterized as individuals at highest risk for lung cancer according to a lung-cancer risk model including age, asbestos exposure and smoking habits. Of these 316, 187 (mean age: 66.6 years) individuals were included in a prospective trial. Mean asbestos exposure time was 29.65 years and 89% were smokers. Screening was performed on a 16-slice MDCT (Siemens) with low-dose technique (10/20 mAs(eff.); 1 mm/0.5 mm increment). In addition to soft copy PACS reading analysis on a workstation with a dedicated lung analysis software (LungCARE; Siemens) was performed. One strongly suspicious mass and eight cases of histologically proven lung cancer were found plus 491 additional pulmonary nodules (average volume: 40.72 ml, average diameter 4.62 mm). Asbestos-related changes (pleural plaques, fibrosis) were visible in 80 individuals. Lung cancer screening in this high-risk cohort showed a prevalence of lung cancer of 4.28% (8/187) at baseline screening with an additional large number of indeterminate pulmonary nodules. Low-dose MDCT proved to be feasible in this highly selected population.
authors.affiliation: Department of Diagnostic Radiology, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany. das@rad.rwth-aachen.de
authors.forename: Marco
authors.initials: M
authors.lastname: Das
authors.forename: Georg
authors.initials: G
authors.lastname: Mühlenbruch
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Mahnken
authors.forename: K G
authors.initials: KG
authors.lastname: Hering
authors.forename: H
authors.initials: H
authors.lastname: Sirbu
authors.forename: W
authors.initials: W
authors.lastname: Zschiesche
authors.forename: Lars
authors.initials: L
authors.lastname: Knoll
authors.forename: Michael K
authors.initials: MK
authors.lastname: Felten
authors.forename: Thomas
authors.initials: T
authors.lastname: Kraus
authors.forename: Rolf W
authors.initials: RW
authors.lastname: Günther
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Wildberger
mesh_terms: D000368:Aged; D001195:Asbestosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008297:Male; D008654:Mesothelioma / Q000000981:diagnostic imaging* / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects*; D011159:Population Surveillance; D011210:Power Plants; D015995:Prevalence; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted; D018570:Risk Assessment; D012307:Risk Factors; D012984:Software; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*