Yip Rowena, Jirapatnakul Artit, Hu Minxia, Chen Xiangmeng, Han Dan, Ma Teng, Zhu Yeqing, Salvatore Mary M, Margolies Laurie R, Yankelevitz David F, Henschke Claudia I
Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Transl Lung Cancer Res. 2021 Feb;10(2):1141-1153. doi: 10.21037/tlcr-20-746.
Low-dose CT screening for lung cancer provides images of the entire chest and upper abdomen. While the focus of screening is on finding early lung cancer, radiology leadership has embraced the fact that the information contained in the images presents a new challenge to the radiology profession. Other findings in the chest and upper abdomen were not the reason for obtaining the screening CT scan, nor symptom-prompted, but still need to be reported. Reporting these findings and making recommendations for further workup requires careful consideration to avoid unnecessary workup or interventions while still maximizing the benefit that early identification of these other diseases provided. Other potential findings, such as cardiovascular disease and chronic pulmonary obstructive diseases actually cause more deaths than lung cancer. Existing recommendations for workup of abnormal CT findings are based on symptom-prompted indications for imaging. These recommendations may be different when the abnormalities are identified in asymptomatic people undergoing CT screening for lung cancer. I-ELCAP, a large prospectively collected multi-institutional and multi-national database of screenings, was used to analyze CT findings identified in screening for lung cancer. These analyses and recommendations were made by radiologists in collaboration with clinicians in different medical specialties.
低剂量CT肺癌筛查可提供整个胸部和上腹部的图像。虽然筛查的重点是发现早期肺癌，但放射学界已经认识到，图像中包含的信息给放射学专业带来了新的挑战。胸部和上腹部的其他发现并非进行筛查CT扫描的原因，也不是由症状引发的，但仍需要报告。报告这些发现并为进一步检查提出建议需要仔细考虑，以避免不必要的检查或干预，同时仍要最大限度地提高早期发现这些其他疾病所带来的益处。其他潜在发现，如心血管疾病和慢性阻塞性肺疾病，实际上导致的死亡比肺癌更多。现有的针对CT异常发现的检查建议是基于有症状提示的影像学检查指征。当在接受肺癌CT筛查的无症状人群中发现异常时，这些建议可能会有所不同。I-ELCAP是一个大型的前瞻性收集的多机构、多国家筛查数据库，用于分析肺癌筛查中发现的CT结果。这些分析和建议是由放射科医生与不同医学专业的临床医生合作完成的。
