Collecting 48,000 CT exams for the lung screening study of the National Lung Screening Trial.
From 2002-2004, the Lung Screening Study (LSS) of the National Lung Screening Trial (NLST) enrolled 34,614 participants, aged 55-74 years, at increased risk for lung cancer due to heavy cigarette smoking. Participants, randomized to standard chest X-ray (CXR) or computed tomography (CT) arms at ten screening centers, received up to three imaging screens for lung cancer at annual intervals. Participant medical histories and radiologist-interpreted screening results were transmitted to the LSS coordinating center, while all images were retained at local screening centers. From 2005-2007, all CT exams were uniformly de-identified and delivered to a central repository, the CT Image Library (CTIL), on external hard drives (94%) or CD/DVD (5.9%), or over a secure Internet connection (0.1%). Of 48,723 CT screens performed, only 176 (0.3%) were unavailable (lost, corrupted, compressed) while 48,547 (99.7%) were delivered to the CTIL. Described here is the experience organizing, implementing, and adapting the clinical-trial workflow surrounding the image retrieval, de-identification, delivery, and archiving of available LSS-NLST CT exams for the CTIL, together with the quality assurance procedures associated with those collection tasks. This collection of CT exams, obtained in a specific, well-defined participant population under a common protocol at evenly spaced intervals, and its attending demographic and clinical information, are now available to lung-disease investigators and developers of computer-aided-diagnosis algorithms. The approach to large scale, multi-center trial CT image collection detailed here may serve as a useful model, while the experience reported should be valuable in the planning and execution of future equivalent endeavors.
Clark
Kenneth W
KW
Mallinckrodt Institute of Radiology, Washington University, 510 South Kingshighway, Saint Louis, MO 63110, USA. clarkk@mir.wustl.edu
Gierada
David S
DS
Marquez
Guillermo
G
Moore
Stephen M
SM
Maffitt
David R
DR
Moulton
Joan D
JD
Wolfsberger
Mary A
MA
Koppel
Paul
P
Phillips
Stanley R
SR
Prior
Fred W
FW
D000368:Aged; D003625:Data Collection; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D011786:Quality Control; D011857:Radiographic Image Interpretation, Computer-Assisted; D013902:Radiography, Thoracic / Q000379:methods*; D011873:Radiology Information Systems / Q000706:statistics & numerical data; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014481:United States
Control Clin Trials. 2000 Dec;21(6 Suppl):251S-272S
11189683
Acad Radiol. 2006 Nov;13(11):1431-41
17111584
Acad Radiol. 2003 Mar;10(3):349-50
12643562
J Digit Imaging. 2007 Mar;20(1):23-31
16783598
Radiology. 2004 Sep;232(3):739-48
15333795
Bioinformatics. 2006 Aug 1;22(15):1910-6
16766552
IEEE Trans Med Imaging. 2006 Nov;25(11):1405-9
17117769
Chest. 2004 Jul;126(1):114-21
15249451
J Digit Imaging. 2005 Sep;18(3):242-50
15924251