Ultralow-dose CT bests X-Ray for lung cancer follow-up, but is it enough?

New AATS president David Sugarbaker, chief of thoracic surgery at Brigham and Women’s Hospital and the Richard E. Wilson Professor of Surgical Oncology at Harvard Medical School, Boston, was not convinced, and suggested that the study essentially describes the detection of new primary tumors following initial resection.

"It’s important to realize that what you’re really talking about is screening patients who’ve had lobar resection for lung cancer," Dr. Sugarbaker said.

"So, I’m not sure you’re conclusion about follow-up detection of metastatic disease is really an accurate description as to what you’ve done, particularly with the inability of minimal-dose CT to assess the mediastinal. Particularly in the larger lesions, where distant metastatic disease may be more frequent, I’m not sure that minimal dose CT is adequate for those patients, where again, mediastinal disease can be the real issue," he said.

Dr. Hanna said that they realize these patients are also at risk of mediastinal disease and that the future will include a more patient-centered approach to surveillance in which patients with a higher risk of distant recurrence will have some other test on top of minimal-dose CT.

Dr. Hanna and his coauthors reported having no study sponsorship or financial disclosures.

pwendling@frontlinemedcom.com