B58-22 Low Dose Non-Contrast Chest CT for Screening of Multiple Diseases With One Exam

Rationale

The National Lung Cancer Screening Trial (NLST) demonstrated a 20% lung cancer-specific mortality reduction and a nearly 7% reduction in all-cause mortality. Since those results were published in 2011, advances in CT technology and artificial intelligence (AI) have significantly improved image quality and diagnostic yield. Low-dose CT (LDCT) of the chest may therefore provide benefits beyond lung cancer detection, particularly in underserved populations with a high burden of comorbidities. The objective of this study was to quantify the prevalence and spectrum of potential actionable clinical findings identified on LDCT lung cancer screening in an underserved population in the Bronx, New York, more than a decade after the NLST trial.

Methods

We conducted a retrospective cohort study of 335 consecutive low dose non-contrast chest CT examinations performed for lung cancer screening between 2020-2024 at Jacobi Medical Center, Bronx, New York. A senior thoracic radiologist with over 25 years of experience reviewed the studies using standardized reporting criteria. Imaging review included standard lung cancer screening findings, with particular emphasis on clinically relevant findings beyond the lungs.

Results

Of the 335 patients screened, the mean age was 62 years and 242 (72%) were male. Pulmonary nodules were identified in 48% of patients, with a mean size of 5.7 mm (range 2-34 mm). Lung-RADS classifications were 50% Lung-RADS 1, 42% Lung-RADS 2, 1% Lung-RADS 3, 3% Lung-RADS 4A and 2 % Lung-RADS 4B. Pulmonary fibrosis was identified in 7% of patients and 15% had emphysema. Beyond pulmonary findings, coronary artery calcifications were present in 55% with a mean visual severity score of 4.3 (maximum 12). 4% had findings suggestive of pulmonary hypertension (PA/aorta ratio >1). 7% had thyroid nodules (mean size 16 mm). Esophageal abnormalities were present in 11%, including esophageal wall thickening in 3%. Hepatic steatosis was present in 9%. Pancreatic atrophy was present in 10%. Osteopenia and osteoporosis were present in 16% and 13% respectively. Breast nodules were present in 2% of patients.

Conclusion

In an underserved population, LDCT lung cancer screening frequently identifies clinically relevant findings beyond lung cancer detection. This study highlights the potential value of LDCT as a broader screening tool in underserved populations and with continued advances in AI assisted image analysis comprehensive reporting of these findings will become more feasible and practical in routine clinical practice.

This abstract is funded by: None