Evaluation of chest radiography and low-dose computed tomography as valuable screening tools for thoracic diseases

Abstract

Background: Recent studies have shown that low-dose computed tomography (LDCT) is effective for the early detection of lung cancer. However, the utility of chest radiography (CR) and LDCT for other thoracic diseases has not been as well investigated as it has been for lung cancer. This study aimed to clarify the usefulness of the veridical method in the screening of various thoracic diseases. Methods: Among individuals who had received general health checkups over a 10-year period, those who had undergone both CR and LDCT were selected for analysis. The present study included 4317 individuals (3146 men and 1171 women). We investigated cases in which abnormal opacity was detected on CR and/or LDCT. Results: A total of 47 and 124 cases had abnormal opacity on CR and LDCT, respectively. Among these, 41 cases in which the abnormal opacity was identified by both methods contained 20 treated cases. Six cases had abnormalities only on CR, and none of the cases required further treatment. Eighty-three cases were identified using LDCT alone. Of these, many cases, especially those over the age of 50 years, were diagnosed with thoracic tumors and chronic obstructive pulmonary disease, which required early treatment. In contrast, many cases of pulmonary infections have improved spontaneously, without any treatment. Conclusion: These results revealed that LDCT allowed early detection of thoracic tumors and chronic obstructive pulmonary disease, especially in individuals over the age of 50 years. CR is still a useful imaging modality for other thoracic diseases, especially in individuals under the age of 49 years.

Which is a real valuable screening tool for lung cancer and measure thoracic diseases, chest radiography or low-dose computed tomography?: A review on the current status of Japan and other countries

“…Recently, new other reports have also shown similar results of the former randomized trial and demonstrated that the utility of LDCT in the early detection and resection of lung cancer and other thoracic malignancy. [10,[20][21][22] These results obtained that LDCT screening may be a better method for lung cancer screening than CR screening.…”

“…[36,37] There are high expectations regarding early detection and implementation of smoking cessation treatments for COPD resulting from LDCT screening. [10] Cigarette smoking is the most commonly encountered and readily identifiable risk factor for COPD, and the early initiation of smoking cessation is important to prevent the exacerbation of COPD. [38][39][40][41][42][43] However, in Japan a major problem is that COPD and its clinical importance have not been well recognized among people.…”

“…The most commonly encountered abnormal lesion among the working-age population is pulmonary infections, whereas lung cancer and COPD are usually detected in older individuals. [ 10 , 44 ] The most frequently identified cause of pulmonary infection is community-acquired pneumonia caused by Streptococcus pneumoniae, Staphylococcus aureus , or Mycoplasma ; the condition usually improves spontaneously. [ 45 ] The recently prevalent SARS-CoV-2 often caused pneumonia; however, after the new omicron outbreak, these cases have now reduced.…”

“…In contrast, recent studies showed the utility of low-dose computed tomography (LDCT) in the early detection and early resection of lung cancer and other thoracic malignancy. [ 10 , 11 ] Recent large randomized trials also showed the efficacy of LDCT in lung cancer screening which contributed to early detection and saved lives compared with screening using CR. [ 12 ] Therefore, we should reconsider that CR screening which recommended in Japan is a valuable method or not for lung cancer.…”

“…On the other hand, CR and LDCT should also be considered important screening tools for other thoracic diseases such as chronic obstructive pulmonary disease (COPD), pulmonary infectious diseases, and cardiovascular disease (CVD) because they are more frequently identified than lung cancer, during health checkups. [ 10 ] Although CR and LDCT have been discussed about mainly in the detection of lung cancer, their utility for screening other thoracic diseases has not been well discussed to date.…”