Diagnostic Imaging's Weekly Scan: Feb. 5, 2021

Low-Dose CT Screening for Never Smokers; PET Imaging and Hormone Therapy; Opportunities, Responsibilities, and Challenges for Women in Radiology; and Advances in Thyroid Cancer Imaging

Welcome to Diagnostic Imaging’s Weekly Scan. I’m senior editor, Whitney Palmer.

Before we get to our featured interview with Dr. Erin Grady from Winship Cancer Institute at Emory University about advancement in molecular imaging for thyroid cancer, here are the top stories of the week.

Low-dose CT screening for detecting lung cancer isn’t just for smokers. Researchers from Taiwan – where more than 50 percent of people who die from lung cancer have never smoked – have determined the scan can also be used to successfully screen high-risk patients who are never-smokers. And, since 10 percent-to-15 percent of patients who develop lung cancer are non-smokers, being able to accurately detect disease is critical. To see whether the screening worked with this group, they enrolled 12,011 non-smoking participants who had at least one risk factor, including family history within third-degree relations, passive smoking exposure, tuberculosis or COPD, a cooking index of 110 or greater, and no ventilation during cooking. Based on their analysis, 17.4 percent of patients were considered positive, and 3.3 percent had lung biopsies or surgery. Ultimately, 2.6 percent of participants received a lung cancer diagnosis – 2.1 percent with invasive disease. Investigators said the results were encouraging because 96.5 percent of cases were early disease that is potentially curable with surgery. The team said they hope their findings can be used to create a risk-score predictor, incorporating family history, as well as genetic and environmental factors, that can pinpoint high-risk never-smokers who would benefit from low-dose CT screening.

Hormone therapy is frequently used to treat women who have breast cancer, but it only works in about half of women who have estrogen receptor-positive disease. Until now, it has been unclear why. Now, researchers from Washington University School of Medicine at St. Louis have identified that the answer to this question likely comes down to whether a women’s estrogen receptors are working properly, and they published their work in Nature Communications. The team built their study around the theory behind estrogen receptor functionality and the corresponding increase in the number of progesterone receptor molecules produced on the surface of cancer cells. They used a PET imaging agent – FFNP – that results in a higher PET signal as more progesterone receptors appear. The team performed PET scans with FFNP on 43 women and followed the studies with three estrogen doses over 24 hours. Women were re-scanned with PET the following day. Based on their assessment, the team found PET signals in tumors increased in 28 women after estrogen exposure, but 15 women saw little-to-no change in the number of progesterone receptors. Those 15 women experienced worsening cancer at follow-up while those who did respond saw stability or improvement. These findings show that it is possible to identify which women with estrogen receptor-positive breast cancer are most likely to respond to hormone therapy, helping providers pursue the best treatment options for individual patients.

This week, we celebrated National Women Physicians Day, memorializing the 200th anniversary of the birthday of America’s first female physician, Elizabeth Blackwell. In recent decades, women have gradually grown to account for nearly 50 percent of medical residents. The story, though, is different in radiology – only 26 percent of radiology residents are women. Diagnostic Imaging had the opportunity this week to talk with women leaders in the specialty – Dr. Mary C. Mahoney, the current president of RSNA, and Dr. Barbara Hamilton, chief of interventional radiology with RadPartners – about the opportunities, responsibilities – and, yes, challenges – that exist for women in the field. They shared their insights into how healthcare can create a more inclusive, diverse environment, as well as their thoughts on various initiatives that are in place to help grow a more welcoming environment for radiology.

And, finally, this week, Diagnostic Imaging spoke with Dr. Erin Grady, associate professor of radiology and director of nuclear medicine education in the Winship Cancer Institute at Emory University, about the latest advances in molecular imaging with thyroid cancer, as well as what the future might hold. Here’s what she shared.

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