Could opportunistic screening be driving the evolution of low-dose CT from a screening test just for lung cancer into a broader one-stop exam for multiple chest pathologies? A new study in JACR suggests as much – and provides a blueprint for how to do it.
There’s no question LDCT lung cancer screening is gaining traction around the world. But as screening programs are starting, clinicians are finding that CT scans can detect far more than just lung cancer.
- Emphysema, commonly associated with COPD, is one such condition, as it goes hand-in-hand with lung cancer in people with long smoking histories. Another is coronary artery calcium (CAC), a known risk factor for cardiovascular disease.
In the new study, researchers wanted to investigate the prevalence of COPD and CAC in their LDCT screening program covering three hospitals in the NewYork-Presbyterian system.
- In addition to documenting prevalence rates, they wanted to connect clinical outcomes to social determinants of health, which have been demonstrated to affect patient care.
They tracked results from 2.4k people who got baseline LDCT scans from 2015 to 2022, finding…
- Emphysema was detected in 77% of patients, and CAC in 65%.
- 87% of patients with emphysema had no previous diagnosis.
- The proportion of patients getting pulmonary care after their LDCT scan increased (from 24% to 46%), as did the rate of those getting cardiovascular care (from 43% to 63%).
- Lower household income was associated with 57% higher adjusted odds of emphysema, and food insecurity with 52% higher odds.
- No social determinants of health were associated with CAC burden.
It’s worth noting that the study did not use any IT tools to classify COPD and CAC, like AI image analysis or longitudinal tracking and reporting.
- It’s entirely possible that the results could be even more promising given the plethora of algorithms that have become available for opportunistic screening applications.
The Takeaway
The new study on incidental CAC and emphysema findings on LDCT exams shows that lung screening has the potential for opportunistic disease detection even if you don’t have fancy AI algorithms at your disposal. All you need are radiologists and clinical staff dedicated to providing better patient care.
