40. Co-operative Study to Establish a Lung Cancer Screening System using CT Units
Toru Matsumoto, Tadaaki Miyamoto, Susumu Kandatsu, Kyosan Yoshikawa, Kiminori Suzuki1, Yuko Sunami1, Keiichi Nagao2, Yoshiaki Masuda2, Hisao Itoh2, Hidemi Oowada2, Takayuki Kuriyama2, Takehiko Fujisawa2, Takaichiro Suzuki3, Chikazumi Kuroda3, Hiroyuki Tajima4, Akinobu Yoshimura4, Tsuyoshi Yano5, Mitsuomi Matsumoto6, Toru Nakagawa7, Yukinori Kusaka7, Shinnji Yamamoto9, Yuichi Fujino10, Kenichi Kaneki11,( 1Chiba Anti-TB Association; 2 Chiba University; 3 Osaka Medical Center for Cancer and Cardiovascular Diseases; 4 Nippon Medical School; 5 Arakawa City Cancer Prevention Center; 6 Tokyo Metropolitan University of Health Sciences, 7 Hitachi Health Care Center; 8 Fukui Medical School; 9 Toyohashi University of Technology; 10 NTT Cyber Solution Laboratories; 11 Hitachi Medical Corp.)
Keywords: lung cancer, CT, cancer screening
In 1998, the total number of deaths from lung cancer in Japan (50,867) exceeded that (50,662) from stomach cancer, which was until then the most common cause of death in Japan. In this abstract, we introduce research activities concerning lung cancer screening using CT units.
Rolled chest radiophotographs or conventional chest X-rays have generally been the most common imaging means for lung cancer screening. Since it is considered difficult to identify lung tumors smaller than 2 cm in diameter without metastasis in 1990, we suggested detecting small tumors at an early stage by lung cancer screening CT (LSCT). In 1992, we developed a low-dose CT unit (tube current: 3mA -140mA) for LSCT. In 1994 and 1996, we developed two vehicles equipped with an LSCT and initiated a study on a lung cancer screening system using two mobile CT units and two LSCTs in two cooperating institute. Approximately 23 regular researchers and 16 cooperative members have joined this research project, including experts from both medical and engineering fields.
The main aim was to establish an LSCT system that allows efficient early detection of lung cancer. At present, pilot studies of lung cancer screening using CT units are going on for the future development of a thoracic CT screening system by examining the popuation living in the Kanto and Kansai regions. Step-1 is an aplication for the secondary screening with an LSCT following mass screening with rolled chest radiographs and step-2 is application for a primary screening with an LSCT.
We have also studied the basic, technical, and epidemiologica problems incidental to the introduction of a new modality in mass screening; namely, estimation of the exposure dose of LSCT, evaluation of diagnostic efficacy of LSCT, risk-benefit analysis and cost- effectiveness analysis of the LSCT system, development of a computer aided diagnosis(CAD) system for screening of lung cancer, and construction of a network-based LSCT system, etc. ( Fig.14).
We consider that the LSCT can promote early detection of peripheral lung cancers and the benefits of LSCT will exceed the risk for Japanese over 40 years of age for males and over 45 years of age for females.
1) Tateno, Y., Iinuma, T., Matsumoto, T., et al; Sin-Iryo,10: 28-32,1990 ( in Japanese)
2) Nisizawa, K., Kawai, K., Matsumoto, T., et al; Estimation of the exposure and a risk benefit analysis for a CT system designed for a lung cancer mass screening using mobile CT., Radiat Protect Dosimet, 67(2):101-108,1996
3) Matsumoto, T., Miyamoto, T., Suzuki, T., et al; Elsevier Science B.V.; Excerpta Medica International Congress Series 1153: Advances in the Prevention of Occupational respiratory Diseases, Proc. of the 9th Internatonal Conference on Occupational Respiratory Diseases, 485-489, 1998
4) Takizawa, H., Yamamoto, Fukano, G., et al; Proc. of Image Processing, part of SPIE's Medical Imaging 2000, 1(24)(SPIE vol.3979), 998-1007, 2000
Fig.14. The lung cancer screening system using CT units.
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