Cinematic Rendering of CT Scans Can Assist Surgeons in Preparation for Surgery

MedicalResearch.com Interview with:

Christian Krautz, MD Department of Surgery, Universitätsklinikum Erlangen Friedrich-Alexander-Universität Erlangen Nürnberg Erlangen, Germany

Dr. Krautz

Christian Krautz, MD
Department of Surgery, Universitätsklinikum Erlangen
Friedrich-Alexander-Universität Erlangen Nürnberg
Erlangen, Germany 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In this preclinical study that included 720 case evaluations, visualization with Cinematic Rendering allowed a more correct and faster comprehension of the surgical anatomy compared to conventional CT imaging independent from the level of surgical experience. Therefore,Cinematic Rendering is a tool that may assist HPB surgeons with preoperative preparation and intraoperative guidance through an improved interpretation of computed tomography imaging data.

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AI: Deep Learning Algorithms Can Detect Critical Head CT Findings

MedicalResearch.com Interview with:
Qure-ai.jpgSasank Chilamkurthy

AI Scientist,
Qure.ai

MedicalResearch.com: What is the background for this study?

Response: Head CT scan is one of the most commonly used imaging protocols besides chest x-ray. They are used for patients with symptoms suggesting stroke, rise in intracranial pressure or head trauma. These manifest in findings like intracranial haemorrhage, midline shift or fracture.

Scans with these critical findings need to be read immediately. But radiologists evaluate the scans on first-come-first-serve basis or based on stat/routine markers set by clinicians. If the scans with critical findings are somehow pushed to the top of radiologists’ work list, it could substantially decrease time to diagnosis and therefore decrease mortality and morbidity associated with stroke/head trauma.

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How Common is Overdiagnosis of Lung Cancer with Low Dose CT Screening?

MedicalResearch.com Interview with:
“CT Scan” by frankieleon is licensed under CC BY 2.0Dr. Bruno Heleno MD PhD

Assistant Professor | Professor Auxiliar
NOVA Medical School | Faculdade de Ciências Médicas
Universidade Nova da Lisboa 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Danish Lung Cancer Screening Trial (DLCST) is a randomized controlled trial which enrolled 4104 participants (aged 50-70 years; current or former smokers; ≥20 pack years; former smokers must have quit <10 years before enrollment) to either 5 rounds of screening for lung cancer with low-dose CT-scans or to no screening.

After 10 years of follow-up, there was a 2.10 percentage points lung cancer absolute risk increase with low-dose CT-screening. Overdiagnosis, i.e. the detection of cancer that would not progress to symptoms or death, was estimated at 67.2% of the screen-detected cancers.

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Annual CT Lung Cancer Screening Among Former Smokers Remains Underutilized

MedicalResearch.com Interview with:

Ahmedin Jemal, DVM, PHD Vice President, Surveillance and Health Services Research American Cancer Society, Inc. 250 Williams St. Atlanta, GA 30303

Dr. Ahmedin Jemal

Ahmedin Jemal, DVM, PHD
Vice President, Surveillance and Health Services Research
American Cancer Society, Inc.
250 Williams St.
Atlanta, GA 30303

MedicalResearch.com: What is the background for this study?

Response: In December 2013, the United States Preventive Services Task Force (USPSTF) recommended annual screening for lung cancer with low dose computed tomography (LDCT) for current or former heavy smokers who quit within the past 15 years.

A previous study estimated that only 2-4% of heavy smokers received LDCT for lung cancer screening in 2010 in the United States. We sought to determine whether lung cancer screening among high risk smokers increased in 2015, following the USPSTF recommendation in 2013.

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Many CT Scans Can Be Avoided During ER Evaluation of Head Trauma

MedicalResearch.com Interview with:

Adam L. Sharp MD MS Research Scientist/Emergency Physician Kaiser Permanente Southern California Kaiser Permanente Research Department of Research & Evaluation Pasadena, CA 91101

Dr. Adam Sharp

Adam L. Sharp MD MS
Research Scientist/Emergency Physician
Kaiser Permanente Southern California
Kaiser Permanente Research
Department of Research & Evaluation
Pasadena, CA 91101

MedicalResearch.com: What is the background for this study?

Response: Millions of head computed tomography (CT) scans are ordered annually in U.S. emergency Departments (EDs), but the extent of avoidable imaging is poorly defined. Ensuring appropriate use is important to ensure patient outcomes and limited resources are optimized. A large number of stake holders have highlighted the need to reduce “unnecessary” CT scanning as part of their recommendations for the Choosing Wisely campaign. However, despite calls for improved stewardship, the extent of avoidable CT use among adults with minor trauma in community EDs is not known.

The Canadian CT Head Rule (CCHR) is perhaps the most studied of many validated decision instruments designed to assist providers in evaluating patients with minor head trauma. This study aims to describe the scope of overuse of CT imaging by ED providers in cases where application of the CCHR could have avoided imaging.

Secondarily, we sought to describe the extent to which avoidable CTs, if averted, would have resulted in “missed” intracranial hemorrhages requiring a neurosurgical intervention.

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Lung Cancers Detected On Screening CT Scans Have Better Survival

MedicalResearch.com Interview with:

Matthew B. Schabath PhD Department of Cancer Epidemiology H. Lee Moffitt Cancer Center and Research Institute Tampa, Florida

Dr. Matthew Schabath

Matthew B. Schabath PhD
Department of Cancer Epidemiology
H. Lee Moffitt Cancer Center and Research Institute
Tampa, Florida

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our study is a post-hoc analysis of data from a large randomized clinical trial (RCT) called the National Lung Screening Trial (NLST). The NLST found that lung cancer screening with low-dose helical computed tomography (LDCT) significantly reduced lung cancer deaths by 20 percent compared to screening with standard chest radiography (i.e., X-Ray).

In our publication, we performed a very detailed analysis comparing outcomes of lung cancer patients screened by LDCT according to their initial (i.e., baseline), 12 month, and 24 month screening results. We found that patients who had a negative baseline screening but tested positive for lung cancer at the 12- or 24-month screen had lower survival and higher mortality rates than patients who had a positive initial screen that was a non-cancerous abnormality but developed lung cancer in subsequent screens.

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Recommended Low-dose CT Scanning For Lung Cancer Often Not Understood or Implemented

MedicalResearch.com Interview with:

Jan Marie Eberth, PhD Assistant Professor, Department of Epidemiology and Biostatistics Deputy Director, SC Rural Health Research Center Core Faculty, Statewide Cancer Prevention and Control Program Arnold School of Public Health University of South Carolina Columbia, SC 29208

Dr. Jan Marie Eberth

Jan Marie Eberth, PhD
Assistant Professor, Department of Epidemiology and Biostatistics
Deputy Director, SC Rural Health Research Center
Core Faculty, Statewide Cancer Prevention and Control Program
Arnold School of Public Health
University of South Carolina
Columbia, SC 29208

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Large, randomized clinical trials have shown that chest x-rays do not reduce mortality from lung cancer. Low-dose computed tomography (LDCT) screening, however, was shown to reduce lung cancer mortality by 20% in the National Lung Screening Trial.

The most significant risk of LDCT screening is the high rate of false-positives (about 25%), which subsequent studies have shown can be reduced by using new nodule management criteria such as Lung-RADS. Less than half of the physicians surveyed in our study reported reduced lung cancer mortality as a benefit of LDCT screening. Many also reported concerns about radiation exposure (50%) and unnecessary follow-up procedures (88%) as risks. Since the majority of family physicians surveyed did not know that organizations such as the US Preventive Services Task Force or National Comprehensive Cancer Network recommend high-risk individuals receive annual LDCT screening, it is not surprising that some family physicians would continue to order a chest x-ray for screening, despite the lack of scientific evidence. Similarly, only 36% of physicians reported that high-risk patients should be screened annually (vs. every 6 months, 2 years, or 3 years).

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Some Nodules on CT Scans More Likely to Be Lung Cancer In Women

Phillip Boiselle, M.D. Staff, Cardiothoracic Imaging Beth Israel Deaconess Medical Center Associate Dean for Academic and Clinical Affairs Professor of Radiology, Harvard Medical School Boston, Mass

Dr. Boiselle

MedicalResearch.com Interview with:
Phillip Boiselle, M.D.
Staff, Cardiothoracic Imaging
Beth Israel Deaconess Medical Center
Associate Dean for Academic and Clinical Affairs
Professor of Radiology, Harvard Medical School
Boston, Mass

Medical Research: What is the background for this study? What are the main findings?

Dr. Boiselle: Previous studies have shown that women have a greater mortality benefit from lung cancer screening then men, and that this test (CT screening) is more cost-effective for women than men. Our purpose was to determine whether the relative risk of lung cancer for women and men differed depending on the specific type of lung nodule that was discovered at screening. Such differences could potentially help to influence a more personalized approach to patient management in lung cancer screening.

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More CT Scans Done For Minor Head Trauma Than Guidelines Recommend

Dr. Jennifer Marin MD MSc Director of Emergency Ultrasound, Division of Pediatric Emergency Medicine Assistant Professor of Pediatrics and Emergency Medicine University of Pittsburgh School of MedicineMedicalResearch.com Interview with:
Dr. Jennifer Marin MD MSc

Director of Emergency Ultrasound
Division of Pediatric Emergency Medicine
Assistant Professor of Pediatrics and Emergency Medicine
University of Pittsburgh School of Medicine

Medical Research: What is the background for this study? What are the main findings?

Dr. Marin: Overuse of diagnostic imaging in the emergency department has become a focus of concern from policy makers, patients, and physicians. There are evidence-based clinical decision rules and policy recommendations published in order to optimize the use of such imaging. However, physicians don’t necessarily use these tools in their decision-making. Head computed tomography (CT) imaging for patients with minor head trauma is a common CT performed in the emergency setting. Our study sought to evaluate how often physicians adhered to the American College of Emergency Physicians (ACEP) Clinical Policy on Neuroimaging. The policy outlines which patients warrant a CT in the setting of minor head trauma based on certain factors, such as age, mechanism of injury, and signs and symptoms of head trauma. What we found is that when the policy recommends that a head CT be performed, it is obtained more than 90% of the time. However, when a head CT is not recommended, it is actually obtained in nearly half of those patients. We hope this will draw attention to decision rules and clinical policies, such as that from ACEP, and remind physicians that using these tools can assist in appropriate imaging practices.
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CT Angiograms Improve Outcomes and Save Lives

Dr. Matthew Budoff, M.D. Los Angeles Biomedical Research Institute Torrance CaliforniaMedicalResearch.com Interview with:
Dr. Matthew Budoff, M.D.
Los Angeles Biomedical Research Institute
Torrance California

Medical Research: What are the main findings of the study?

Dr. Budoff: We evaluated whether patients undergoing coronary CT angiography (non-invasive angiography) had better outcomes than those treated without the test.  We found survival was better with CT angiography.    Finding atherosclerosis allows cardiologists and primary care doctors to treat the patient better, including more statin therapy, more anti-platelet therapy, more lifestyle modifications.  Several small studies showed similar results, but this was by far the most significant and largest study of it’s kind.
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Pulmonary Fibrosis: High Resolution CT Diagnosis

Ganesh Raghu, M.D.,FCCP, FACP Professor of Medicine & Lab Medicine (Adjunct) Division of Pulmonary & Critical Care Medicine University of Washington(UW) Director,CENTER for Interstitial Lung Disease(ILD),UW Medicine, ILD, Sarcoid and Pulmonary Fibrosis Program Co-Director, Scleroderma Clinic, UW Medical center(UWMC) Seattle, WA 98195MedicalResearch.com Interview with:
Ganesh Raghu, M.D.,FCCP, FACP
Professor of Medicine & Lab Medicine (Adjunct)
Division of Pulmonary & Critical Care Medicine
University of Washington(UW)
Director,CENTER for Interstitial Lung Disease (ILD),UW Medicine,
ILD, Sarcoid and Pulmonary Fibrosis Program
Co-Director, Scleroderma Clinic, UW Medical center(UWMC)
Seattle, WA 98195

MedicalResearch.com: What are the main findings of the study?

Dr. Raghu: In a subgroup of patients with typical clinical features of Idiopathic pulmonary fibrosis ( IPF) , further evaluation by a thorough evlauation by regional experts experienced in management of idiopathic pulmonary fibrosis and related diseases may lead to a diagnosis of idiopathic pulmonary fibrosis without the need for surgical lung biopsy if the HRCT features have a Possible-UIP pattern AND if there are no suspicion for environmental factors or collagen vascular diseases to explain the pulmonary fibrosis .
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Lung Cancer: Screening with Low-Dose CT

MedicalResearch.com Interview with:
Linda L. Humphrey, M.D., M.P.H.
Professor of Medicine
Informatics and Clinical Epidemiology and Public Health for Oregon Health & Science University;Associate Chief of Medicine at the Portland VA Medical Center

Dr. Humphrey comments on this important study on
Screening for Lung Cancer With Low-Dose Computed Tomography:

Lung cancer is the 3rd leading cause of cancer in the United States and the leading cause of cancer related death.  It is estimated that in 2012 there were 226,160 cases of lung cancer and 160, 340 lung cancer related death in the US.   In addition, lung cancer is the leading cause of years of life lost to cancer.   Cigarette smoking is by far the leading cause of lung cancer in the US and while many people have quit smoking, data in the US indicate that 37% of adults are either current or former smokers and at risk of lung cancer.    Continue reading

Lung Cancer Screening CT Scans Can Predict Future Cardiovascular Events

Dr. Pim A. de Jong,
Department of Radiology
University Medical Center Utrecht,
Heidelberglaan 100, E.01.132, 3508GA
Utrecht, the Netherlands.

MedicalResearch.com: What are the main findings of the study?

Dr. de Jong: The main findings of the study is that lung cancer screening CT scans can predict future cardiovascular events.

MedicalResearch.com: Where any of the findings unexpected?

Dr. de Jong: The unexpected aspect is that the CT scans were not-ECG gated, but even these non-gated scans were good enough to quantify arterial calcifications and predict risk.
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CT Scan Exposure in Childhood or Youth and Cancer Risk

prof_john_d_mathewsJohn D. Mathews, MBBS, MD, PhD, DSc Hon, DMedSc Hon,
Professor of epidemiology at the School of Population and Global Health,
University of Melbourne,
Carlton, Victoria, Australia

Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians

MedicalResearch.com: What are the main findings of the study?

Prof Mathews: We found that for persons having at least one CT scan before the age of 20 years, and followed for an average period of 10 years, the average risk of cancer was increased by 24% compared with unexposed persons matched for age, sex and year of birth. The cancer risk increased by 16% for each CT scan that preceded the cancer by more than one year. The proportional increase in risk was greater for persons exposed at younger ages.
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