title: Collecting 48,000 CT exams for the lung screening study of the National Lung Screening Trial.
abstract: 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.
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University, 510 South Kingshighway, Saint Louis, MO 63110, USA. clarkk@mir.wustl.edu
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Clark
authors.forename: David S
authors.initials: DS
authors.lastname: Gierada
authors.forename: Guillermo
authors.initials: G
authors.lastname: Marquez
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Moore
authors.forename: David R
authors.initials: DR
authors.lastname: Maffitt
authors.forename: Joan D
authors.initials: JD
authors.lastname: Moulton
authors.forename: Mary A
authors.initials: MA
authors.lastname: Wolfsberger
authors.forename: Paul
authors.initials: P
authors.lastname: Koppel
authors.forename: Stanley R
authors.initials: SR
authors.lastname: Phillips
authors.forename: Fred W
authors.initials: FW
authors.lastname: Prior
mesh_terms: 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
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