Short-term health-related quality of life consequences in a lung cancer CT screening trial (NELSON)

Item does not contain fulltextBACKGROUND: In lung cancer CT screening, participants often have an indeterminate screening result at baseline requiring a follow-up CT. In subjects with either an indeterminate or a negative result after screening, we investigated whether health-related quality of life (HRQoL) changed over time and differed between groups in the short term. METHODS: A total of 733 participants in the NELSON trial received four questionnaires: T0, before randomisation; T1, 1 week before the baseline screening; T2, 1 day after the screening; and T3, 2 months after the screening results but before the 3-month follow-up CT. HRQoL was measured as generic HRQoL (the 12-item Short Form, SF-12; the EuroQol questionnaire, EQ-5D), anxiety (the Spielberger State-Trait Anxiety Inventory, STAI-6), and lung-cancer-specific distress (the Impact of Event Scale, IES). For analyses, repeated-measures analysis of variance was used, adjusted for covariates. RESULTS: Response to each questionnaire was 88% or higher. Scores on SF-12, EQ-5D, and STAI-6 showed no clinically relevant changes over time. At T3, IES scores that were clinically relevant increased after an indeterminate result, whereas these scores showed a significant decrease after a negative result. At T3, differences in IES scores between the two baseline result groups were both significant and clinically relevant (P<0.01). CONCLUSION: This longitudinal study among participants of a lung cancer screening programme showed that in the short term recipients of an indeterminate result experienced increased lung-cancer-specific distress, whereas the HRQoL changes after a negative baseline screening result may be interpreted as a relief

The effect of iterative reconstruction on computed tomography assessment of emphysema, air trapping and airway dimensions.

Item does not contain fulltextOBJECTIVES: To determine the influence of iterative reconstruction (IR) on quantitative computed tomography (CT) measurements of emphysema, air trapping, and airway wall and lumen dimensions, compared to filtered back-projection (FBP). METHODS: Inspiratory and expiratory chest CTs of 75 patients (37 male, 38 female; mean age 64.0 +/- 5.7 years) were reconstructed using FBP and IR. CT emphysema, CT air trapping and airway dimensions of a segmental bronchus were quantified using several commonly used quantification methods. The two algorithms were compared using the concordance correlation coefficient (p (c)) and Wilcoxon signed rank test. RESULTS: Only the E/I-ratio(MLD) as a measure of CT air trapping and airway dimensions showed no significant differences between the algorithms, whereas all CT emphysema and the other CT air trapping measures were significantly different at IR when compared to FBP (P < 0.001). CONCLUSION: The evaluated IR algorithm significantly influences quantitative CT measures in the assessment of emphysema and air trapping. However, the E/I-ratio(MLD) as a measure of CT air trapping, as well as the airway measurements, is unaffected by this reconstruction method. Quantitative CT of the lungs should be performed with careful attention to the CT protocol, especially when iterative reconstruction is introduced. KEY POINTS : * New techniques in CT allow numerous quantitative measurements of lung function. * Iterative reconstruction influences quantitative CT measurements of emphysema and air trapping. * Expiratory-to-inspiratory ratio of mean lung density and airway measurements are unaffected by iterative reconstruction. * Quantitative lung-CT should be performed with careful attention to the CT protocol.1 oktober 201