Lower Dosage CT-guided Lung Biopsy May Reduce Overall Lung Cancer Deaths

New guidelines that call for lower radiation exposure from CT-guided biopsies of lung nodules allows more people to undergo the procedure and may result in fewer overall lung cancer deaths, said researchers at the Society of Interventional Radiology’s 37th Annual Scientific Meeting in San Francisco, Calif.

CT is more sensitive than chest X-rays and other imaging tests in detecting lung nodules, but there has been concern about the risk of cumulative exposure through the imaging. Researchers from Northwestern University in Chicago, Ill., studied the findings for 100 patients for whom they used new CT imaging parameters, which downshifts the amount of energy the CT scanner used to produce images and moderates the current of the X-ray tube to put out smaller doses during the examination. This allowed for a drop in exposure but maintained image quality.  Fifty of the patients had undergone previous CT-guided biopsies prior to the protocol and the other half after the protocol went into effect.

The results showed a 66 percent drop in radiation dose without any degradation of the images for all of the CT-guided biopsies.

“We found that simple modifications to the CT technique used for guidance to perform lung biopsies resulted in a significant dose reduction to the individuals treated,” said Jeremy Collins, MD, assistant professor of radiology at Northwestern. When the lower-dose technique was used, mortality from lung cancer was reduced by 20 percent compared to X-ray screening alone.

Although more testing needs to be done to tailor the protocol, Collins said, “The new protocol can be adopted immediately to reduce exposure, but interventional radiologists will still need to evaluate each person on a case-by-case basis, especially smaller people or those who have an anatomy that is more difficult to image.”