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From the frontlines to the frontier: CT trends and innovations

by Lauren Dubinsky , Senior Reporter
From the November 2018 issue of DOTmed HealthCare Business News magazine

In December 2013, the USPSTF recommended annual low-dose CT screening for lung cancer for patients 55 to 80 years old with a 30 pack-year smoking history, and who currently smoke or who quit in the last 15 years. CMS followed up with its decision to provide coverage for these exams in February 2015.

Dr. Ella Kazerooni
“This has been very beneficial to this patient population,” said Dr. Ella Kazerooni, service chief of diagnostic radiology at University of Michigan Medicine. “This is the leading cause of cancer death in the U.S. and abroad, for which there has been no screening test.”
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She added that while many people are familiar with screening for breast and colon cancer, they are not always aware that there are similar services for detecting lung cancer.

When a patient is diagnosed with lung cancer, her department works closely with the pulmonary medicine department to ensure they are getting their follow-up CT scans at the three- or six-month mark. She noted that it’s important not to let any patient “fall through the cracks.”

Although Kazerooni stressed that the financial aspects of lung cancer screening are far less important than the medical appropriateness of the exams, she doesn’t think costs should prohibit other providers from implementing their own programs.

“If an institution were to look at the economics, they would find it to be very viable even after the investment in the supporting staff and technology that’s required,” she said. “I think they should not think of the economic side as an obstacle to their practice.”

For all the lifesaving value of low dose CT lung cancer screening, analysis shows that the scans have also been plagued by a high rate of false positives. In an effort to address this, Fox Chase Cancer Center in Philadelphia received a $673,000 grant from the U.S. Department of Defense in August to develop a test that detects early-stage lung cancer and can serve as a secondary screening option for patients with inconclusive lung CT scans.

Fox Chase and the Philadelphia VA Medical Center are planning on enrolling patients in a study later this year to evaluate the efficacy of the new test.

Breast CT… without radiation?
Although CT and radiation are commonly thought to go hand-in-hand, Lihong Wang, professor of medical and electrical engineering at The California Institute of Technology (Caltech), doesn’t believe computed tomography has to be thought of in that way.
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