Ning Wu MD, Presenter: Nothing to Disclose

Daniel M. Libby, Abstract Co-Author: Nothing to Disclose

In-Jae Lee MD, Abstract Co-Author: Nothing to Disclose

Ali Omer Farooqi MBBS, Abstract Co-Author: Nothing to Disclose

David Fred Yankelevitz MD, Abstract Co-Author: Nothing to Disclose

Claudia Ingrid Henschke MD, Abstract Co-Author: Nothing to Disclose

James Smith MD, Abstract Co-Author: Nothing to Disclose

Mark Pasmantier MD, Abstract Co-Author: Nothing to Disclose

Dorothy McCauley MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Although computerized tomography (CT) screening discovers lung cancer in stage I over eighty per cent of the time, many benign noncalcified nodules are also found. We recognized that some nodules appeared to represent infectious bronchopneumonia or other inflammatory processes, as they resolved on follow-up CT, sometimes after antibiotic therapy. To determine the extent to which short term CT radiographic follow-up might shorten the work-up of nodules, we reviewed our experience with baseline and annual repeat CT screenings performed subsequent to the original Early Lung Cancer Action Project (ELCAP) series.

The initial CT of 1,968 consecutive baseline and 2,343 annual repeat screenings performed in 1999-2002 was reviewed. We identified all those recommended for antibiotics on the initial CT and who had a follow-up CT within 2 months. We determined whether the nodule(s) resolved, decreased in size, remained unchanged or grew on the follow-up CT. For cases of growth, no change or partial resolution, we determined whether further follow-up resulted in a diagnosis of cancer.

At baseline, among the 41 individuals for whom antibiotics was recommended based on the initial CT, 12 (29%) had complete or partial resolution; none of them were subsequently diagnosed with lung cancer. On annual repeat screening, among the 39 individuals for whom antibiotics were recommended, 29 (74%) had complete or partial resolution; none of them were subsequently diagnosed with lung cancer. Among the 29 with nodules at baseline which were unchanged or grew, a total of 15 cancers were subsequently diagnosed and among the 10 on annual repeat, there were 2 cancers.

In asymptomatic individuals undergoing CT screening for lung cancer, short term follow-up CT within two months and judicious use of empiric antibiotics may circumvent the need for further evaluation in a significant proportion of individuals, particularly on annual repeat screening.

Wu, N, Libby, D, Lee, I, Farooqi, A, Yankelevitz, D, Henschke, C, Smith, J, Pasmantier, M, McCauley, D, et al, , CT Screening for Lung Cancer: The Value of Short-term CT Follow-up and Antibiotics.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4409476.html