From the January/February 2011 issue of HealthCare Business News magazine
Advancements in early detection
Among the four most prevalent deadly cancers, lung cancer has the lowest five-year survival rate: a mere 15 percent. In light of NLST’s findings, it’s imperative that lung cancer be found and diagnosed at the earliest and most treatable stage. The challenge is that early-stage detection can be difficult as symptoms are generally not present until the cancer has grown to a significant size. It can then trigger a persistent cough, chest pain or shortness of breath. Typically, detection of early stage lung cancer is a result of a patient receiving a chest X-ray or CT scan for a different issue, such as a broken rib or pneumonia.
The NLST study suggests spiral CT scans were better at finding lung nodules, as they can detect smaller lesions that may otherwise be missed on a traditional chest X-ray, but the study did not have the benefit of newer X-ray technologies able to enhance X-rays and improve lung nodule detection.
Maximizing information in a chest X-ray
Since the study started in 2002, significant advancements to enhance chest X-ray technology have been developed and commercialized. Enhanced chest imaging technology and software applications have been shown to significantly improve the visibility of nodules on chest X-rays. Multi-reader studies have shown the use of software that uses advanced algorithms to suppress the bone on every chest X-ray can improve the detection of nodules by more than 15 percent. Moreover, data demonstrates that radiologists who use certain CAD technology for chest X-rays can improve the detection of nodules and detect up to 50 percent of missed nodules. The use of these technologies can significantly improve the sensitivity of chest X-rays to detect more lung cancer without additional radiation exposure to the patient or specialized imaging equipment.
Another technology that enhances a traditional chest X-ray is dual-energy subtraction (DES) technologies, which use a combination of dedicated hardware and software to form the soft tissue image where rib and clavicles are suppressed from the X-ray image. These DES solutions are effective in obtaining a soft tissue image; however, they require dedicated hardware and additional patient radiation dose.
Lastly, there’s been some discussion recently about blood biomarker and breathalyzer technologies that show promise in detecting lung cancer. These non-invasive breakthroughs analyze certain biomarkers in a person’s blood, in tissue or in particles in the breath to detect the presence of lung cancer cells. Furthermore, DNA tests are on the horizon to assess a patient’s predisposition to lung cancer.
