Medical imaging has long been used as a tool in the detection of cancer. However, radiologists must be selective about who should have certain types of medical imaging studies and how frequently. Ionizing radiation can raise cancer risk, so doctors have to balance the risks and benefits of screening techniques that involve medical imaging that uses ionizing radiation.
Fortunately, newer imaging techniques use less ionizing radiation or none at all, and doctors are better able to identify which patients benefit most from screening for various types of cancer. In some cases, medical imaging can detect problems before they turn cancerous, maximizing a patient’s treatment options. Here are some examples.
Monitoring Lung Nodules With Low Dose CT
Non-solid lung nodules can be caused by infection or inflammation, but sometimes they are pre-cancerous. Researchers at Icahn School of Medicine at Mount Sinai have developed a way to use computed tomography (CT) scanning to help identify which cases of non-solid lung nodules are more likely to become cancerous while sparing patients from unnecessary surgery.
Just over 4% of baseline low-dose CT screenings in the study identified non-solid nodules. Of nearly 2,400 baseline screenings showing non-solid nodules, 73 cases of cancer were diagnosed. Annual repeat screenings identified new non-solid nodules in a small percentage of participants, and 11 of these were diagnosed with Stage I cancer. But in 22 cases, non-solid nodules developed a solid component, showing possibly invasive cancer.
The transition from non-solid to part-solid nodules took more than two years, indicating that monitoring non-solid nodules with low-dose CT every 12 months is sufficient. This type of monitoring may prevent over-treatment of lung nodules, according to researchers, and could be a major improvement in lung cancer screening protocols.
CT Scans and Lung Cancer Screening in Smokers
A recent study in Utah based on the National Lung Screening Trial compared CT scans and chest x-rays for detecting lung cancer. It found that past smokers who received CT scans had lower risk of dying from lung cancer compared to those who received chest x-rays. Program lead and pulmonologist Denitza Blagev, MD says that the “best practices” developed from the Lung Cancer Screening Program led to three early diagnoses that may not have been made otherwise during the program’s first 18 months.
Study participants were considered at high risk for lung cancer due to smoking history. Two-hundred seventy-two eligible patients were screened with CT scans, and 19 of those scans found evidence of cancer. Eleven cases were confirmed malignant. Of these, eight were confirmed to have lung cancer and three of those eight were considered early stage disease, when more treatment options are available.
Lung Cancer Isn’t the Only Cancer Benefiting from New Screening Protocols
Mammography has been found to reduce breast cancer deaths among women in the 40 to 74 age group, particularly for women over age 50. Some women, however, carry a harmful genetic mutation that raises their risk of breast and other types of cancer. In these women, magnetic resonance imaging (MRI) may be used as a screening tool.
Last year, a rapid MRI protocol was studied by researchers at the University Hospital of Aachen in Germany and found to be a superior medical imaging technology for breast cancer because there’s no ionizing radiation involved, it’s highly sensitive, and there is less risk of over-diagnosis. Researchers developed a three-minute MRI protocol and found its accuracy was similar to that of a full diagnostic MRI, which takes around 20 minutes.
There are still issues, however, with patient friendliness, since MRI requires injection of a contrast agent, and is significantly more expensive than traditional mammography. However, for women at high risk of breast cancer, the level of detail MRI produces is considered a smart trade-off due to the increased chance of catching cancers early.
SteleRAD Radiologists’ Experience in Cancer Screening
Medical imaging and cancer screening have long gone together. Each year, physicians learn more about which types of medical imaging are most beneficial to which patients. This allows better use of medical and financial resources and can prevent unnecessary tests and surgeries. Increasingly, radiologists like SteleRAD’s Eric L. Alboucrek, DO, who has extensive breast imaging experience, and Brian Auster, MD, who has completed MRI fellowships, are able to tailor the use of medical imaging to specific patient needs to protect people’s health and maximize chances of early cancer detection.
SteleRAD is owned and operated by Board-certified radiologists who serve South Florida hospitals, practices, and imaging facilities with every type of medical imaging specialty. To learn more, call SteleRAD at 954-358-5250, or contact us online at any time.