Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed
The ITALUNG trial started in 2004 and compared lung cancer (LC) and other-causes mortality in 55–69 years-aged smokers and ex-smokers who were randomized to four annual chest low-dose CT (LDCT) or usual care. ITALUNG showed a lower LC and cardiovascular mortality in the screened subjects after 13 ye...
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-06-01
|
| Series: | Diagnostics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2075-4418/13/13/2197 |
| _version_ | 1827735008426590208 |
|---|---|
| author | Mario Mascalchi Giulia Picozzi Donella Puliti Stefano Diciotti Annalisa Deliperi Chiara Romei Fabio Falaschi Francesco Pistelli Michela Grazzini Letizia Vannucchi Simonetta Bisanzi Marco Zappa Giuseppe Gorini Francesca Maria Carozzi Laura Carrozzi Eugenio Paci |
| author_facet | Mario Mascalchi Giulia Picozzi Donella Puliti Stefano Diciotti Annalisa Deliperi Chiara Romei Fabio Falaschi Francesco Pistelli Michela Grazzini Letizia Vannucchi Simonetta Bisanzi Marco Zappa Giuseppe Gorini Francesca Maria Carozzi Laura Carrozzi Eugenio Paci |
| author_sort | Mario Mascalchi |
| collection | DOAJ |
| description | The ITALUNG trial started in 2004 and compared lung cancer (LC) and other-causes mortality in 55–69 years-aged smokers and ex-smokers who were randomized to four annual chest low-dose CT (LDCT) or usual care. ITALUNG showed a lower LC and cardiovascular mortality in the screened subjects after 13 years of follow-up, especially in women, and produced many ancillary studies. They included recruitment results of a population-based mimicking approach, development of software for computer-aided diagnosis (CAD) and lung nodules volumetry, LDCT assessment of pulmonary emphysema and coronary artery calcifications (CAC) and their relevance to long-term mortality, results of a smoking-cessation intervention, assessment of the radiations dose associated with screening LDCT, and the results of biomarkers assays. Moreover, ITALUNG data indicated that screen-detected LCs are mostly already present at baseline LDCT, can present as lung cancer associated with cystic airspaces, and can be multiple. However, several issues of LC screening are still unaddressed. They include the annual vs. biennial pace of LDCT, choice between opportunistic or population-based recruitment. and between uni or multi-centre screening, implementation of CAD-assisted reading, containment of false positive and negative LDCT results, incorporation of emphysema. and CAC quantification in models of personalized LC and mortality risk, validation of ultra-LDCT acquisitions, optimization of the smoking-cessation intervention. and prospective validation of the biomarkers. |
| first_indexed | 2024-03-11T01:44:14Z |
| format | Article |
| id | doaj.art-a837d480a3ca428c9bb773f087b11001 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T01:44:14Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-a837d480a3ca428c9bb773f087b110012023-11-18T16:21:21ZengMDPI AGDiagnostics2075-44182023-06-011313219710.3390/diagnostics13132197Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be AddressedMario Mascalchi0Giulia Picozzi1Donella Puliti2Stefano Diciotti3Annalisa Deliperi4Chiara Romei5Fabio Falaschi6Francesco Pistelli7Michela Grazzini8Letizia Vannucchi9Simonetta Bisanzi10Marco Zappa11Giuseppe Gorini12Francesca Maria Carozzi13Laura Carrozzi14Eugenio Paci15Department of Clinical and Experimental Biomedical Sciences “Mario Serio”, University of Florence, 50121 Florence, ItalyDivision of Epidemiology and Clinical Governance, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50100 Florence, ItalyDivision of Epidemiology and Clinical Governance, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50100 Florence, ItalyDepartment of Electrical, Electronic, and Information Engineering “Guglielmo Marconi”, University of Bologna, 47521 Cesena, ItalyRadiodiagnostic Unit 2, Department of Diagnostic Imaging, Cisanello University Hospital of Pisa, 56124 Pisa, ItalyRadiodiagnostic Unit 2, Department of Diagnostic Imaging, Cisanello University Hospital of Pisa, 56124 Pisa, ItalyRadiodiagnostic Unit 2, Department of Diagnostic Imaging, Cisanello University Hospital of Pisa, 56124 Pisa, ItalyPulmonary Unit, Cardiothoracic and Vascular Department, University Hospital of Pisa, 56124 Pisa, ItalyDivision of Pneumonology, San Jacopo Hospital Pistoia, 51100 Pistoia, ItalyDivision of Radiology, San Jacopo Hospital Pistoia, 51100 Pistoia, ItalyRegional Laboratory of Cancer Prevention, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50100 Florence, ItalyDivision of Epidemiology and Clinical Governance, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50100 Florence, ItalyDivision of Epidemiology and Clinical Governance, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50100 Florence, ItalyRegional Laboratory of Cancer Prevention, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50100 Florence, ItalyPulmonary Unit, Cardiothoracic and Vascular Department, University Hospital of Pisa, 56124 Pisa, ItalyDivision of Epidemiology and Clinical Governance, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50100 Florence, ItalyThe ITALUNG trial started in 2004 and compared lung cancer (LC) and other-causes mortality in 55–69 years-aged smokers and ex-smokers who were randomized to four annual chest low-dose CT (LDCT) or usual care. ITALUNG showed a lower LC and cardiovascular mortality in the screened subjects after 13 years of follow-up, especially in women, and produced many ancillary studies. They included recruitment results of a population-based mimicking approach, development of software for computer-aided diagnosis (CAD) and lung nodules volumetry, LDCT assessment of pulmonary emphysema and coronary artery calcifications (CAC) and their relevance to long-term mortality, results of a smoking-cessation intervention, assessment of the radiations dose associated with screening LDCT, and the results of biomarkers assays. Moreover, ITALUNG data indicated that screen-detected LCs are mostly already present at baseline LDCT, can present as lung cancer associated with cystic airspaces, and can be multiple. However, several issues of LC screening are still unaddressed. They include the annual vs. biennial pace of LDCT, choice between opportunistic or population-based recruitment. and between uni or multi-centre screening, implementation of CAD-assisted reading, containment of false positive and negative LDCT results, incorporation of emphysema. and CAC quantification in models of personalized LC and mortality risk, validation of ultra-LDCT acquisitions, optimization of the smoking-cessation intervention. and prospective validation of the biomarkers.https://www.mdpi.com/2075-4418/13/13/2197biomarkerscoronary artery calcificationsemphysemalow-dose CTlung cancerlung nodules |
| spellingShingle | Mario Mascalchi Giulia Picozzi Donella Puliti Stefano Diciotti Annalisa Deliperi Chiara Romei Fabio Falaschi Francesco Pistelli Michela Grazzini Letizia Vannucchi Simonetta Bisanzi Marco Zappa Giuseppe Gorini Francesca Maria Carozzi Laura Carrozzi Eugenio Paci Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed Diagnostics biomarkers coronary artery calcifications emphysema low-dose CT lung cancer lung nodules |
| title | Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed |
| title_full | Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed |
| title_fullStr | Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed |
| title_full_unstemmed | Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed |
| title_short | Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed |
| title_sort | lung cancer screening with low dose ct what we have learned in two decades of italung and what is yet to be addressed |
| topic | biomarkers coronary artery calcifications emphysema low-dose CT lung cancer lung nodules |
| url | https://www.mdpi.com/2075-4418/13/13/2197 |
| work_keys_str_mv | AT mariomascalchi lungcancerscreeningwithlowdosectwhatwehavelearnedintwodecadesofitalungandwhatisyettobeaddressed AT giuliapicozzi lungcancerscreeningwithlowdosectwhatwehavelearnedintwodecadesofitalungandwhatisyettobeaddressed AT donellapuliti lungcancerscreeningwithlowdosectwhatwehavelearnedintwodecadesofitalungandwhatisyettobeaddressed AT stefanodiciotti lungcancerscreeningwithlowdosectwhatwehavelearnedintwodecadesofitalungandwhatisyettobeaddressed AT annalisadeliperi lungcancerscreeningwithlowdosectwhatwehavelearnedintwodecadesofitalungandwhatisyettobeaddressed AT chiararomei lungcancerscreeningwithlowdosectwhatwehavelearnedintwodecadesofitalungandwhatisyettobeaddressed AT fabiofalaschi lungcancerscreeningwithlowdosectwhatwehavelearnedintwodecadesofitalungandwhatisyettobeaddressed AT francescopistelli lungcancerscreeningwithlowdosectwhatwehavelearnedintwodecadesofitalungandwhatisyettobeaddressed AT michelagrazzini lungcancerscreeningwithlowdosectwhatwehavelearnedintwodecadesofitalungandwhatisyettobeaddressed AT letiziavannucchi lungcancerscreeningwithlowdosectwhatwehavelearnedintwodecadesofitalungandwhatisyettobeaddressed AT simonettabisanzi lungcancerscreeningwithlowdosectwhatwehavelearnedintwodecadesofitalungandwhatisyettobeaddressed AT marcozappa lungcancerscreeningwithlowdosectwhatwehavelearnedintwodecadesofitalungandwhatisyettobeaddressed AT giuseppegorini lungcancerscreeningwithlowdosectwhatwehavelearnedintwodecadesofitalungandwhatisyettobeaddressed AT francescamariacarozzi lungcancerscreeningwithlowdosectwhatwehavelearnedintwodecadesofitalungandwhatisyettobeaddressed AT lauracarrozzi lungcancerscreeningwithlowdosectwhatwehavelearnedintwodecadesofitalungandwhatisyettobeaddressed AT eugeniopaci lungcancerscreeningwithlowdosectwhatwehavelearnedintwodecadesofitalungandwhatisyettobeaddressed |