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Lung cancer is an increasing burden to the Chinese society. Early detection by computed tomography (CT) can improve survival. The management of incidental lung nodules on CT is traditionally based on two-dimensional (2D) measurements, with multiple repeat scans to assess growth. In lung cancer screening setting, 3D volumetry was found more accurate.
In this project, we first analyse the current diagnostic management of lung nodules in a Chinese clinical setting. Through the Dutch-Chinese collaboration we have access to a large at-risk group for developing lung cancer (pulmonology patients). In a future follow-up study, we investigate the cost-efficiency and time to diagnosis by applying the new 3D volumetry method.
There is an existing collaboration with the Chinese group in scientific research, in particular a PhD exchange program. Dr Yingru Zhao, who will be involved in the current project, performed and completed her PhD at the Center for Medical Imaging/ Radiology department of the University Medical Center Groningen, in 2013. The PhD students in the exchange program are involved in analysis of data from the Dutch-Belgian Lung Cancer Screening Trial (NELSON), which has radiological coordination from Groningen. One of the topics that the Chinese PhD students have investigated, is the role of 3D volumetry for early diagnosis of lung cancer in low-dose CT lung cancer screening. The results of the PhD work were published in top-25 radiology journals. One of the studied topics was the value of 3D volumetry over 2D measurements for assessing screen-detected lung nodules. Translating the results from the PhD projects to the Chinese situation will further intensity the Dutch-Chinese collaboration and contribute to cost-efficient diagnosis of early lung cancer in the clinical setting.
Improving efficiency of early lung cancer diagnosis in patient care by volumetry of CT-detected lung nodules
The incidence and mortality rate of lung cancer have been increasing worldwide. Especially in China, with a high percentage of smokers, lung cancer is a devastating problem that is predicted to even increase in the future with the ageing of the population. Patients with lung cancer usually present at a stage that the disease has already spread to other parts of the body (metastasized). The 5-year survival rate for lung cancer patients is therefore very low (less than 15% of the patients are surviving 5 years). Timely and accurate detection of small tumors that are still at an early stage, before symptoms occur, is crucial to improve the prognosis of lung cancer. Although the vast majority of solid pulmonary nodules (SPNs) are benign, a percentage of them represent early lung cancer that is still treatable. Recent data from lung cancer screening studies suggest that the prognosis of lung cancer improves considerably if detected at an early stage by computed tomography (CT). Different CT screening studies have shown that lung nodules are present in 25 tot 50% of smokers over 50 years of age.
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