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The value of low dose spiral CT scan in diagnosis of pulmonary nodules

Author: WengZuoZuo
Tutor: LiLongZuo
School: Beijing Union Medical College
Course: Clinical
Keywords: LDCT Pulmonary nodules Cancer screening
CLC: R816.41
Type: PhD thesis
Year: 2010
Downloads: 5
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Objective:To quantitate the effectiveness of low-dose spiral computed tomography (LDCT) in the identification of pulmonary nodules.Materials and methods:The prospective study included302patients who underwent LDCT scan of the chest in our hospital for the assenssment of pulmonanry nodules from2002to2010. Compare the numbers of nodules detected at chest X-ray, SDCT and LDCT.Results:302patients,156men and146women. Participants were divided into two groups:(a)230patients who took LDCT scan because of suspected pilmonanry nodules with chest X-ray or SDCT,120men,110women,94.0%age>40,79had a history of cigarette smoking,30had a history of occupational exposure (to asbestos or radon).95paetiets were asymptomatic,112were high-risk individuals,60patients underwent chest X-ray and LDCT scan, the LDCT-detected nodules were2.4times of that detected by chest X-ray.164patients underwent the CT examination at both standard and low dose, the LDCT-detected nodules were1.2times of that detected by SDCT. There were no statistically significant diffenrences in the imaging characters of the nodules detected at SDCT and LDCT. Biopsy of15lesions revealed lung cancer in7subjects,3.0%(7/230), with a high proportion of early tumor stages71.4%(5tumors, stage I),8lesions were benign.(b)In72patients who had a history of tumor, nodules were detected in68patients,26lesions were metastasis. Biopsy of1lesion revealed lung cancer, stage Ⅰ.Conclusion:The LDCT scan can be used more reliably in detection of pulmonary nodules than chest X-ray. Compared with SDCT, LDCT scan had not only reduced the radiation dose, but also had no statistically significant diffenrences in detecting of pulmonanry nodules and lung cancer. Cancer screening Of high-risk individuals will increase the numbers of lung cancer which were detected at early stage, prolong overall survival. Moreover, LDCT also increase the diagnosis of benign diseases of lung. A number of unresolved issues must be answered, such as wheather lung caner screening with LDCT will decrease in lung caner mortality, potential radiation risk, high false positive rate, the time of repeating screening and its cost-effectiveness. Tumor patients who were followed-up by LDCT, will find lung metastasis earlier than chest X-ray.Compared with SDCT,much safer.

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CLC: > Medicine, health > Of Medical > Radiation Medicine > Each location and course of disease X - ray diagnosis and therapy > Chest and respiratory system > The lungs
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