Lower dose CT scans for lung cancer diagnosis

Bay Area doctors are now using a new screening strategy that could detect lung cancers much earlier.
October 10, 2013 9:32:22 PM PDT
Lung cancer is often a killer diagnosis once the disease has progressed. Now Bay Area doctors are using a new screening strategy that could detect lung cancers much earlier.

Pamela Daniels is a former smoker who's now hooked on exercise following surgery to remove a lesion in her lung.

"After the surgery all I could do was walk. They said, walk, walk, walk," she remembers.

Doctors at John Muir Hospital say the lesion was spotted in the early stages, not by a traditional chest X-ray, but a CT scan. The CT or CAT scan is high-end imaging technology that sends a series of X-ray beams into the body to produce a detailed three-dimensional image. It's being used by doctors at John Muir as part of a nationwide clinical trial designed to gauge its effectiveness at spotting lung cancer in high risk patients.

"A CT can help us look at detail, anatomic detail, to a much greater extent than a chest X-ray," says lead radiologist Sunil Gandhi, M.D.

He says CT scans can highlight even tiny nodules inside the lung. But the machines also use higher levels of radiation in the process, as much as 100 times that of a simple X-ray. This trial, known as I-ELCAP, is using low dose CT?about 15 times the dose of an X-ray.

"So we reduce the dose tremendously on these exams compared to a conventional chest CT," Dr. Gandhi explains.

Experts say recent improvements in the technology allow for superior screening images, even at the lower doses.

It was the type used in Daniel's case. Her surgeon, Michaela Strasnicka, MD says her team was able to remove Daniel's lesion while it was still contained to the lung -- a major advantage for a disease that often isn't diagnosed until the patient begins experiencing symptoms.

"When the lung cancers or any cancers spread outside of the primary site of disease, whether it's into the lymph nodes or into other organs or surrounding structures, the stage increases, and the chance of a curative resection decreases," says Strasnicka.

An independent government panel is now recommending low dose CT screenings for smokers and former smokers between the ages of 55 and 80.

For Daniels it's offered her a second chance -- one she doesn't intend to waste.

"I would have kept on smoking, because I really didn't have any big desire to quit," she remembers. "Although I had always said, 'Something's going to scare the mess out of me one of these days, and it'll make me quit,' and it did."

CT screenings for lung cancer are typically not covered by insurance. If the recommendation from the national preventative task force is finalized, it's expected to result in much broader coverage.

Written and produced by Tim Didion


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