Source: International Congress 2014 – Risk assessment and tracheal reconstructions
Disease area: Thoracic oncology

Abstract

BACKGROUND. In Low-Dose CT (LDCT) screening programs for Lung Cancer (LC), radiation exposure and costs are still problems. SOS study was single-arm observational study of chest Digital Tomosynthesis (DT) for LC-detection in an at-risk population. DT is limited angle tomography that allows reconstruction of multiple image planes and provides high-resolution images in coronal planes.METHODS. Accrual of study participants started in December 2010, ended in December 2011. Eligible: smokers or former smokers (45-75 years), smoking history ³20 pack-years, without malignancy in 5 years before. DT was performed at baseline and another the following year. In subjects with uncertain nodule >5 mm or multiple nodules, first-line LDCT was warranted.RESULTS. Of 1919 candidates assessed, 1843 (96%) were enrolled into study (77% currently smokers). 1843 baseline DT were obtained. Pulmonary abnormalities were detected in 14.5% subjects. First-line LDCT was carried out in 7.2%. LC was detected in 18 (0.98%). 1,703 (92% of baseline, drop out=0.4%) first round DT were obtained. New lung nodules >5 mm were detected in 13 (0.7%). LC was diagnosed in 5 subjects with First Round LC detection rate 0.3%. Overall LC detection rate was 1.25%.

Tumor stage and histology in subjects with LC diagnosed by chest DT

	No. of subjects
TUMOR STAGE	Baseline	First Round
IA	6	4
IB	2
IIA	2	1
IIB	1
IIIA	1
IIIB	1
IV	5
HISTOLOGY	Baseline	First Round
Adenocarcinoma	10	1
Squamous cell carcinoma	7	4
Carcinoid	1

CONCLUSIONS. LC detection rate was comparable to LDCT (0.98%) with low effective radiation dose (0.13 mSv), and 1/6 cost. DT is possible first-line LC screening tool and is effective in high-risk subjects follow-up.

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Citations should be made in the following way:
L. Bertolaccini, A. Viti, M. Grosso, A. Terzi, L. Bertolaccini (Negrar Verona, Cuneo, Italy). SOS study: Lung cancer detection with chest digital tomosynthesis. Eur Respir J 2014; 44: Suppl. 58, 1918

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