Lower-dose radiation scan for lung disease

People with systemic sclerosis may be able to have their lungs monitored for a complication of the condition using a scan that cuts their exposure to radiation.

INTRODUCTION

People with systemic sclerosis have an abnormal growth of connective tissue. This affects their skin, digestive tract, and other internal organs. It causes thickening of the skin and damage to blood vessels. For some people it causes damage to the lungs, called interstitial lung disease.

People with systemic sclerosis have their health checked regularly so that problems can be treated quickly as they arise. These checks usually include a CT scan of the chest to check for signs of interstitial lung disease. But regular screening with CT scans means regular exposure to radiation.

WHAT DID THE RESEARCHERS HOPE TO FIND?

The researchers wanted to see whether a partial chest scan using a lower radiation dose worked as well as the standard scan. CT scans take an image of a ‘slice’ through the lung. The standard ‘whole-chest’ scans take images of many slices, close together throughout the whole chest. The reduced dose scans used in the study took just nine slices spaced through the chest.

WHO WAS STUDIED?

The study included 205 patients being treated for systemic sclerosis at University Hospital, Zurich. All patients were having annual checks for progression of the condition.

HOW WAS THE STUDY CONDUCTED?

The patients all had both types of scan during their annual check-up. Two independent readers checked the images from the scans. The researchers looked to see whether the scans using lower-dose radiation picked up all the cases of interstitial lung disease that had been diagnosed by the whole-chest scans.

WHAT DOES THE NEW STUDY SAY?

The readers picked up 88 in every 100 cases of interstitial lung disease using the lower-dose radiation scans. This means that the lower-dose scans were able to pick up most cases of early disease.
The radiation dose from the lower-dose scans was much lower than the whole-chest scan dose.

HOW RELIABLE ARE THE FINDINGS?

It is likely that the results of the study are reliable. However, we don’t know whether people reading the scans in other hospitals, who might have been trained in a different way, might have come to different conclusions.

WHAT DOES THIS MEAN FOR ME?

If you have systemic sclerosis, this might be a way to monitor you for early signs of lung disease while protecting you from much of the radiation dose of whole-chest scans. This is something you might want to discuss with your doctor.

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Date summary prepared: December 2014

Summary based on research article published on: 30 September 2014

From: Frauenfelder, T. et al. Screening for interstitial lung disease in systemic sclerosis: performance of high-resolution CT with limited number of slices: a prospective study. Ann Rheum Dis 2014;73:2069-2073 doi:10.1136/annrheumdis-2014-205637

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