191 research outputs found

    Lung cancer screening

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    Lung cancer screening with CT remains controversial. Lung cancer is the leading cause of cancer death. To date, no screening test has been demonstrated to reduce mortality. Given the large population of adult cigarette smokers and former smokers worldwide, there is a large population at risk for lung cancer. While a lot has been learned from prospective single-arm cohort studies about the feasibility of performing annual CT to screen for lung cancer, many questions have also been raised. While we know that screening for lung cancer with CT detects many small nodules, with up to half the subjects having a positive baseline screen, and up to 75% of subjects having a positive screen at least once if screened annually for 5 years, the great majority of these nodules exhibit benign biologic behavior. The innumerable small nodules detected with screening CT, and diagnostic chest CT in general, present a daily clinical challenge, and result in extensive medical resource utilization and additional radiation exposure. Algorithms for how and when to follow small nodules detected on CT are in evolution. Ongoing studies are designed to determine if lung cancer screening with CT reduces lung cancer mortality.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47978/1/10406_2005_Article_134.pd

    Reference absolute and indexed values for left and right ventricular volume, function and mass from cardiac computed tomography

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    Introduction Left ventricular ( LV ) and right ventricular ( RV ) volumetric and functional parameters are important biomarkers for morbidity and mortality in patients with heart failure. Purpose To retrospectively determine reference mean values of LV and RV volume, function and mass normalised by age, gender and body surface area ( BSA ) from retrospectively electrocardiographically gated 64‐slice cardiac computed tomography ( CCT ) by using automated analysis software in healthy adults. Materials and Methods The study was approved by the institutional review board with a waiver of informed consent. Seventy‐four healthy subjects (49% female, mean age 49.6 ± 11) free of hypertension and hypercholesterolaemia with a normal CCT formed the study population. Analyses of LV and RV volume (end‐diastolic, end‐systolic and stroke volumes), function (ejection fraction), LV mass and inter‐rater reproducibility were performed with commercially available analysis software capable of automated contour detection. General linear model analysis was performed to assess statistical significance by age group after adjustment for gender and BSA . Bland–Altman analysis assessed the inter‐rater agreement. Results The reference range for LV and RV volume, function, and LV mass was normalised to age, gender and BSA . Statistically significant differences were noted between genders in both LV mass and RV volume ( P ‐value < 0.0001). Age, in concert with gender, was associated with significant differences in RV end‐diastolic volume and LV ejection fraction ( P ‐values 0.027 and 0.03). Bland–Altman analysis showed acceptable limits of agreement (±1.5% for ejection fraction) without systematic error. Conclusion LV and RV volume, function and mass normalised to age, gender and BSA can be reported from CCT datasets, providing additional information important for patient management.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109344/1/jmiro12186.pd
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