What you need to know about:

Low-dose Computerized Tomography (LDCT)

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Overview of

Low-dose Computerized Tomography (LDCT)

in Thailand

The number of lung cancer patients is increasing at an alarming rate, with this disease currently the number one cause of death among both males and females in the U.S.A. In Thailand, lung cancer is the leading cause of death among males, and the fifth deadliest disease in females. Low-dose computed tomography (LDCT) is the main procedure for screening and detecting lung cancer. LDCT scans the body and uses low doses of radiation to provide a series of detailed pictures of the lungs. If lung cancer is found in its early stages, it will increase your chance for survival through immediate treatment. However, some cancers can recur, even though found early, since they can spread to other parts of the body. When a cancer is spreading, it is difficult to treat and can often result in death.

Goals of

Low-dose Computerized Tomography (LDCT)

The goal of LDCT lung screening is to detect lung cancer earlier. Without proactive screening and diagnosis, doctors don’t usually find lung cancer until a person develops symptoms. By that time, the cancer is much harder to treat. Patients who should consider this include those who smoke and those who are suspected of being exposed to harmful inhalation substances

Price of

Low-dose Computerized Tomography (LDCT)

Average Cost

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Pros and cons of

Low-dose Computerized Tomography (LDCT)

Pros

-LDCT is able to detect even very small nodules in the lung, which are too small to detect with conventional chest x-ray.

-LDCT is able to detect early lung cancer. Hence, the cancer can be treated before it has spread outside the lung. This reduces lung cancer mortality.

-LDCT is a technique that uses low radiation dose so the patient will expose less radiation than conventional CT.

-IV contrast is not required.

-In patients who have irregularities detected during chest x-rays, it may already be too late for effective treatment to take place. Fortunately, clinical studies have found that screening for early-stage lung cancer with annual low-dose computed tomography (LCDT) procedures have been found to reduce fatality rates by up to 20% among high-risk groups. This is because early-stage lung cancer - which often displays no symptoms whatsoever - can be treated effectively, while the radiation levels patients are exposed to are also lower than when undergoing standard computed tomography chest (CT) examinations.

Cons

-Not all cancers detected by LDCT will be found in the early stage of the disease. Screening that detects lung cancer may not improve your health or help you live longer if the disease has already spread beyond the lungs to other areas of the body.

-LDCT lung cancer screening and all other screening exams can lead to the detection and treatment of cancer which may never have harmed you. This can result in unnecessary treatment, complications and cost.

How it works:

Low-dose Computerized Tomography (LDCT)

A member of staff will help place you in the correct position on the bed, which involves laying on your side and placing both arms by the side of your head. The member of staff will advise you regarding the correct breathing techniques with the aim of reducing internal organ movement, which will help to improve image quality. Patients will usually be required to hold their breath for around 2-5 seconds each time. The bed used during screening will move slowly in and out of the machine. The whole process will takes around 5-10 minutes to complete.

Preparation before

Low-dose Computerized Tomography (LDCT)

Pre - treatment

There is no need for any special preparations on the part of patients, with regular eating and drinking allowed due to the lack of radiation injections. Please contact the computer scanning department 15-30 minutes before your appointment to ensure you are ready for the procedure.If patients are wearing any jewelry and/or other metal accessories, they should remove them when changing into the hospital-provided clothing.

Recovery after

Low-dose Computerized Tomography (LDCT)

Post - treatment

You may resume your daily activites after having a the LDCT scan. A radiologist will read your scan and send your doctor a report. Your doctor will notify you of the results and coordinate follow-up if needed.

Risks & side effects

There are several risks and limitations to using a LDCT:  

-Radiation exposure: LDCT lung screening uses radiation to create images of your lungs. Radiation can increase a person’s risk of cancer. By using special techniques, the amount of radiation in LDCT lung screening is small – about the normal amount received from the sun in a year. Further, your physician has determined the benefits of the screening outweigh the risks of being exposed to the small amount of radiation from this exam.  

-False negative: No test is perfect. It is possible that you may have a medical condition, including lung cancer, that the screening doesn’t reveal. This is called a false negative.  

-False positive/additional testing: A low-dose CT scan often finds something in the lung that could be cancer but in fact is not. This is called a false positive and can cause anxiety. To make sure these findings are not cancer, you may need to have more tests. These tests will be performed only if you give us permission. Occasionally, patients need a procedure, such as a biopsy, that can have potential side effects.  

-Findings not related to lung cancer: Your LDCT lung screening exam also captures images of areas of your body next to your lungs. In a small percentage of cases, 5%-10%, the CT scan will show an abnormal finding in one of these areas, such as your kidneys, adrenal glands, liver, heart vessels or thyroid. This finding may not be serious, but you may need further evaluation. The healthcare provider who ordered your exam can help determine what, if any, additional testing you need.

FAQs:

Low-dose Computerized Tomography (LDCT)

What kind of patients should consider getting this procedure?

It is highly recommend that the following kinds of patients consider getting an LDCT:  

-Heavy smokers, whose age is 55 years or above, who smoke 2o cigarettes per day for the past 30 years constantly or 4o cigarettes per day for the past 15 years constantly, including the ones who quitted smoking for less than 15 years.  

-Patients who have been exposed to a harmful environment for a long period, especially where Asbestos is present.  

-Patients who have a history of chronic lung diseases such as chronic obstructive pulmonary disease (COPD) or chronic bronchitis.  

People who do not meet the criteria in above group, but will gain some benefit from LDCT screening include those who:  

-Have a family member who smokes.

-Have a family member who suffered from lung cancer.

What happens if something is detected on my screening exam?

Lung cancer typically occurs in the form of a lung nodule, an area of abnormal tissue within the lung. Most nodules (more than 95%) do not represent cancer. Instead, they represent areas of scarring in the lung from prior infection or small lymph nodes. If your LDCT scan detects a nodule larger than a certain size, your doctor will likely recommend a follow-up LDCT scan several months later to check that the nodule does not change in size. If the nodule grows or is suspicious, your doctor may recommend further evaluation with a more advanced imaging study such as a contrast-enhanced CT or and/or removal of a small piece of the nodule (called a lung biopsy). A pathologist can analyze the cells from the biopsy under a microscope to determine whether the nodule is malignant (cancerous) or benign.

How often should I have a scan done if I am considered as being high risk?

When a patient falls into the range of high risk, we encourage them to get a scan every year. If the scan doesn’t show anything significant, the patient should continue getting annual screenings until they no longer meet the high-risk criteria. If there is a significant abnormality, we may need to increase the frequency of screenings.

Who is considered high-risk for lung cancer?

People ages 55 to 77 who have smoked at least an average of 1 pack a day for 30 years. This includes people who still smoke or have quit within the past 15 years.

If I meet the criteria for being high-risk but have been diagnosed with cancer in the past, is LDCT lung screening appropriate for me?

It depends. In some cases, LDCT lung screening will not be appropriate, such as when your physician is already following your cancer with CT scan studies. Your physician will help determine if a low-dose CT scan is right for you.

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