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      Computed Tomography: Revolutionizing the Practice of Medicine for 40 Years

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      Journal: Radiology
      Publisher: Radiological Society of North America (RSNA)

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          Computerized transverse axial scanning (tomography). 1. Description of system.

          G N Hounsfield (1973)
          Article 0 comments Cited 407 times – based on 0 reviews     Review now
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            The National Lung Screening Trial: overview and study design.

            Denise R Aberle, Christine D Berg, William C Black … (2011)
            The National Lung Screening Trial (NLST) is a randomized multicenter study comparing low-dose helical computed tomography (CT) with chest radiography in the screening of older current and former heavy smokers for early detection of lung cancer, which is the leading cause of cancer-related death in the United States. Five-year survival rates approach 70% with surgical resection of stage IA disease; however, more than 75% of individuals have incurable locally advanced or metastatic disease, the latter having a 5-year survival of less than 5%. It is plausible that treatment should be more effective and the likelihood of death decreased if asymptomatic lung cancer is detected through screening early enough in its preclinical phase. For these reasons, there is intense interest and intuitive appeal in lung cancer screening with low-dose CT. The use of survival as the determinant of screening effectiveness is, however, confounded by the well-described biases of lead time, length, and overdiagnosis. Despite previous attempts, no test has been shown to reduce lung cancer mortality, an endpoint that circumvents screening biases and provides a definitive measure of benefit when assessed in a randomized controlled trial that enables comparison of mortality rates between screened individuals and a control group that does not undergo the screening intervention of interest. The NLST is such a trial. The rationale for and design of the NLST are presented. © RSNA, 2010
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              Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society.

              Heber MacMahon, John Austin, Gordon Gamsu … (2005)
              Lung nodules are detected very commonly on computed tomographic (CT) scans of the chest, and the ability to detect very small nodules improves with each new generation of CT scanner. In reported studies, up to 51% of smokers aged 50 years or older have pulmonary nodules on CT scans. However, the existing guidelines for follow-up and management of noncalcified nodules detected on nonscreening CT scans were developed before widespread use of multi-detector row CT and still indicate that every indeterminate nodule should be followed with serial CT for a minimum of 2 years. This policy, which requires large numbers of studies to be performed at considerable expense and with substantial radiation exposure for the affected population, has not proved to be beneficial or cost-effective. During the past 5 years, new information regarding prevalence, biologic characteristics, and growth rates of small lung cancers has become available; thus, the authors believe that the time-honored requirement to follow every small indeterminate nodule with serial CT should be revised. In this statement, which has been approved by the Fleischner Society, the pertinent data are reviewed, the authors' conclusions are summarized, and new guidelines are proposed for follow-up and management of small pulmonary nodules detected on CT scans.
              Article 0 comments Cited 246 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Title: Radiology
                Abbreviated Title: Radiology
                Publisher: Radiological Society of North America (RSNA)
                ISSN (Print): 0033-8419
                ISSN (Electronic): 1527-1315
                Publication date Created: November 2014
                Publication date (Print): November 2014
                Volume: 273
                Issue: 2S
                Pages: S45-S74
                Article
                DOI: 10.1148/radiol.14141356
                PubMed ID: 25340438
                SO-VID: 36ab2fb2-4ff4-4e17-ad1b-88d983afc716
                Copyright © © 2014
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