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November 2010
In This Issue...

Worth Repeating...

“This [NLCST] finding has important implications for public health, with the potential to save many lives among those at greatest risk for lung cancer … [but] we don't know the ideal way yet to do this screening.”

— National Cancer Institute Director
Harold Varmus, MD

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Editor’s E-Note

The National Lung Cancer Screening Trial (NLCST) reports that screening certain high-risk smokers and former smokers with CT scans reduced cancer deaths by 20%. The conclusion was so clear that the study was stopped early.

Now the question becomes ‘what action will come from this scientific data?’ Screening policy is only partly drawn from scientific data. It’s also formulated based on emotion, economics, and politics.

What’s next for lung cancer screening is the topic of this issue’s E-News Exclusive.

— Jim Knaub, editor
E-News Exclusive

CT Screening Can Reduce Lung Cancer Deaths; Now What?
By Jim Knaub

“This is the first time that we have seen clear evidence of a significant reduction in lung cancer mortality with a screening test in a randomized controlled trial.”

Christine Berg, MD, of the National Cancer Institute

A 20% reduction in cancer deaths is significant. In the past, one big argument against screening for lung cancer was that there were no well-controlled studies showing that screening actually changed outcomes by reducing deaths. The National Lung Cancer Screening Trial (NLCST) followed 53,000 current or former smokers and showed that reduction.

“This is good news,” Dana-Farber Cancer Institute thoracic oncologist Bruce Johnson, MD, told USA Today. “The reduction in deaths is comparable to mammograms, which reduce deaths by 14% to 15%.”

But results showing fewer deaths alone will not make CT scanning for lung cancer a widespread practice. There are real issues—particularly how to define the high-risk population that will benefit from screening. In addition to determining precisely who should be screened, there are matters of cost, radiation exposure, and false positives—not to mention the sensitive politics and social perceptions about lung cancer. According to the USA Today report, 87% of lung cancer cases are caused by smoking. To phrase it gently, not everyone believes that it’s a high priority to fund research and pay for treatment for a disease that is predominantly caused by a patient’s choosing to smoke.

Full Story »

Currently in Radiology Today

Paper Into PACS
Converting paper documents into a format acceptable to store in a PACS is a widespread need. Imaging facilities use several approaches to solve this common problem, including using DICOM, RIS, or EMR document management. Read more »

Technology Update: Ultrasound
Here’s a look at what is new and innovative in ultrasound equipment.
Read more

Radioimmunotherapy Advancing
Zevalin and Bexxar are FDA approved to treat follicular B-cell non-Hodgkin’s lymphoma. Read about how they’re currently being used in a clinical setting. Read more »

Other Imaging News

FDA Recommends Better CT Training and High-Dose Warnings on Scanners
Better training for technologists using CT scanners and equipment that warns about high dose exposure are the key tools for reducing unnecessary exposure in CT scans, according to this New York Times article.

NLCST: CT Screening Reduces Lung Cancer Deaths
Coverage of the study results reporting a 20% reduction in lung cancer mortality—and what it might mean for lung cancer screening—from USA Today and The New York Times.

Handling ‘Incidentalomas’
MedPage Today reports on new guidance from the ACR on how radiologists and facilities should handle incidental findings.

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