Full-Field Cardiac CT Offers Improved Chance of Incidental Lung Cancer Diagnosis

A retrospective registry of patients undergoing cardiac CT scans suggests that individuals with an increased risk of lung cancer may benefit from a full-field cardiac CT scan. According to researchers at Seoul National University Bundang Hospital, this is because limited-field-of-vision cardiac scans miss 89 percent of the incidental lung cancer findings that could be identified by full-field cardiac CTs.

Due to the high degree of difference between diagnosis effectiveness, the researchers recommend taking risk for lung cancer into account when choosing between a limited-field and full-field CT scan. This recommendation was reached following a review of the Bundang hospital’s database records from 2004 to 2007. This review helped researchers retrospectively determine which patient cases of lung cancer had been initially identified via cardiac CT scan.

Of all patients receiving a cardiac CT scan during that time, 0.31 percent of the scans resulted in findings of lung cancer. Patients with suspected or diagnosed coronary artery disease had a higher rate of lung cancer, at 0.43 percent.

Of the cases in which lung cancer was identified, 86 percent were eventually diagnosed as adenocarcinomas.

While the fraction of patients diagnosed with lung cancer via cardiac CT scan is small, the variance between detection from limited-view and full-view scans is quite large. According to researchers, only 11 percent of the identified lung cancers were achieved via a limited-view cardiac CT scan. In contrast, 53 percent were visible via a full-view cardiac scan and 47 percent were visible via a full-view thoracic CT scan (overlap suggests some cancer cases were identifiable by two or more screening options).

In response to the results of the study, the research team recommends the inclusion of a low-dose whole-thorax CT scan for patients who have a history of smoking and/or an increased risk for coronary artery disease.

Resources: http://www.theheart.org/article/1069819.do