Screening for Early Lung Cancer, Chronic Obstructive Pulmonary Disease, and Cardiovascular Disease (the Big-3) Using Low-dose Chest Computed Tomography: Current Evidence and Technical Considerations

Marjolein A. Heuvelmans, Marleen Vonder, Mieneke Rook, Harry J.M. Groen, Geertruida H. De Bock, Xueqian Xie, Maarten J. Ijzerman, Rozemarijn Vliegenthart, Matthijs Oudkerk* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

34 Citations (Scopus)

Abstract

Lung cancer, chronic obstructive pulmonary disease, and cardiovascular disease are highly prevalent in the general population and expected to cause most deaths by 2050. For these "Big-3," treatment might cure, delay, or stop the progression of disease at a very early stage. Lung nodule growth rate (a biomarker for lung cancer), emphysema/air trapping (a biomarker for chronic obstructive pulmonary disease), and coronary artery calcification (a biomarker for cardiovascular disease) are imaging biomarkers of early stages of the Big-3 that can be acquired with low-dose computed tomography (CT). We hypothesize that a (combined) low-dose CT examination for detection of all 3 diseases may significantly improve the cost-effectiveness of screening in the future. We review the current evidence of the imaging biomarkers for the detection of the Big-3 diseases and present the potential health economic potential of Big-3 screening. Furthermore, we review the low-dose CT protocols to acquire these biomarkers and describe the technical considerations when combining the CT protocols for the different biomarkers.

Original languageEnglish
Pages (from-to)160-169
JournalJournal of Thoracic Imaging
Volume34
Issue number3
Early online date1 Dec 2018
DOIs
Publication statusPublished - 1 May 2019

Keywords

  • UT-Hybrid-D
  • biomarkers
  • cardiovascular diseases
  • emphysema
  • lung neoplasms
  • pulmonary disease, chronic obstructive
  • tomography, x-ray computed
  • arteriosclerosis
  • n/a OA procedure

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