Radiological Report of Pilot Study for the Korean Lung Cancer Screening (K-LUCAS) Project: Feasibility of Implementing Lung Imaging Reporting and Data System

Abstract

ObjectiveTo report the radiological results of a pilot study for the Korean Lung Cancer Screening project conducted to evaluate the feasibility of lung cancer screening using low-dose chest computed tomography (LDCT) in Korea.Materials and MethodsThe National Cancer Center and three regional cancer centers participated in this study. Asymptomatic current or ex-smokers aged 55–74 years with a smoking history of at least 30 pack-years who had used tobacco within the last 15 years were considered eligible. In total, 256 participants underwent LDCT November 2016 through March 2017. The American College of Radiology Lung Imaging Reporting and Data System (Lung-RADS) was used to categorize the LDCT findings.ResultsIn total, 57%, 35.5%, 3.9%, and 3.5% participants belonged to Lung-RADS categories 1, 2, 3, and 4, respectively. Accordingly, 7.4% participants exhibited positive findings (category 3 or 4). Lung cancer was diagnosed in one participant (stage IA, small cell lung cancer). Other LDCT findings included pulmonary emphysema (32.8%), coronary artery calcification (30.9%), old pulmonary tuberculosis (11.7%), bronchiectasis (12.9%), interstitial lung disease with a usual interstitial pneumonia pattern (1.2%), and pleural effusion (0.8%).ConclusionEven though the size of our study population was small, the positive rate of 7.4% was like or lower than those in other lung cancer screening studies. Early lung cancer was detected using LDCT screening in one participant. Lung-RADS may be applicable to participants in Korea, where pulmonary tuberculosis is endemic.

<p>Effectiveness and Feasibility of Complementary Lung-RADS Version 1.1 in Risk Stratification for pGGN in LDCT Lung Cancer Screening in a Chinese Population</p>

“…Lung-RADS category 2 (benign appearance) represents as negative screening results, while categories 3 (probably benign) and 4 (suspicious) represent positive results. 15 Since most of MIA or AIS, even part of invasive adenocarcinoma may appear as pGGNs companied with a well-circumscribed interface, 16 the majority of pGGNs were categorised as 2 or 3 according to the Lung-RADS version 1.1, which might increase the rate of underdiagnosis. Biological tumor studies have revealed that vasculature remodeling or neoangiogenesis is one of the first occurring events in the early stage of tumor development.…”

<p>Landscape on CT screening for lung cancer in Asia</p>

“…In 2017, a K-LUCAS Project, a 2-year multicenter lung cancer screening pilot project, was initiated to as evaluate the effectiveness and feasibility of lung cancer screening and validate new standards for the reporting form of LDCT and the quality of the screening by a web-based network system, and develop a risk prediction model for lung cancer 74,76. This project was sponsored by National Cancer Center and collaborated with Multidisciplinary Expert Committee.…”

Size-Specific Dose Estimation In the Korean Lung Cancer Screening Project: Does a 32-cm Diameter Phantom Represent a Standard-Sized Patient in Korean Population?

“…Specifically, in the National Lung Screening Trial, in current or ex-smokers aged 55–74 years who had a smoking history of at least 30 pack-years and had quit within the last 15 years, lung cancer specific mortality was 20.0% lower in the LDCT screening arm than in the chest X-ray screening arm ( 1 ). On the basis of this result, the Korean Lung Cancer Screening (K-LUCAS) project had been launched and the pilot study for K-LUCAS was performed to evaluate the feasibility on the implementation of national screening with LDCT for high-risk subject of lung cancer ( 2 ).…”