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More Lung Cancers Detected With Full Field of View

Limited field of view at scanning misses most cancers detected with full view; majority found resectable

FRIDAY, April 23 (HealthDay News) -- The prevalence of lung cancer detected at cardiac computed tomography (CT) is 0.31 percent, with most of the malignancies at resectable stages; however, when a limited field of view (FOV) is used at cardiac scanning, a large majority of lung cancers detected at full thoracic scanning are missed, according to research published in the May issue of Radiology.

Tae Jung Kim, M.D., of the Seoul National University Bundang Hospital in South Korea, and colleagues used a lung cancer patient registry database to identify patients with lung cancer initially detected at cardiac CT between 2004 and 2007. They excluded patients known to have lung cancer at the time of cardiac CT. They also compared rates of detection at three FOV settings: limited and full FOV at cardiac scanning and full FOV at thoracic scanning.

The researchers found that lung cancer prevalence detected in those undergoing cardiac CT scanning was 0.31 percent. Among those with suspected or diagnosed coronary artery disease, the prevalence of lung cancer was higher (0.43 percent); asymptomatic patients undergoing screening cardiac CT had a lower prevalence of lung cancer (0.20 percent). Eighty-six percent of the cancers were adenocarcinomas, and 68 percent of the 34 non-small cell lung cancers were resectable. FOV was a significant factor in detection of these cancers; 11 percent were visible with a limited FOV at cardiac screening, 53 percent with a full FOV at cardiac screening, and 47 percent with a full FOV at thoracic scanning only.

"These results suggest that to avoid a false sense of security, it should be clearly documented whether the entire lung or only part of the lung was evaluated in the cardiac CT examination. Given that a substantial number of lung cancers go undetected, even with full-FOV cardiac scanning, and that patients who undergo cardiac CT may have a smoking history, a coexistent risk factor for both coronary artery disease and lung cancer, low-dose whole-thorax CT for extracardiac evaluation might be performed before cardiac scanning, with an acceptable range of radiation exposure," the authors write.

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