t
RADIOLOGY & IMAGING
Transforming early diagnoses
Equipping radiologists with software developed using machine-learning algorithms has led to significantly more cancerous structures or nodules being detected than via human-only readings in clinical studies. Daniel Drieling MeVis Medical Solutions examines the increasingly important support role of artificial intelligence.
Being the number one cancer globally, across populations of men and women combined, lung cancer is notoriously challenging to spot sufficiently early to enable positive treatment outcomes. In 2018, lung cancer accounted for 2.09 million of cancer cases globally, and some 1.76 million deaths – more than twice the number of the next biggest killer cancer (colorectal), according to the World Health Organization.1
The problem is that symptoms of lung cancer tend to occur predominantly in the late stages of the disease, when successful treatment becomes more and more difficult. Unlike various other types of cancer, such as breast cancer (accounting for 627,000 deaths in 2018), which can be checked for in a number of different ways, lung cancer requires targeted medical imaging to determine what’s going on.
Better targeting of screening
Because of the high rates of lung cancer, and the poor prognosis when it is found too late in patients, governments internationally are increasingly launching strategic screening campaigns. One example is NHS England’s mobile lung health checks. Here, portable CT scanners are being dispatched to areas of the country where rates of lung disease are found to be higher than average. The thinking is that by looking out for the earliest signs of problems among at-risk groups (smokers, those working in potentially harmful environments, and so on), health services will save more lives, and reduce the significant long-term costs of trying to treat late-stage cancer.
Around £70 million will fund 10 projects that check those most at risk, inviting them for an MOT for their lungs and an on the spot
chest scan that include mobile clinics. The targeted screening will help improve survival rates by going first to the some of the areas with the highest death rates from lung cancer. The roll out has the potential to reach around 600,000 people over four years, detecting approximately 3400 cancers and saving hundreds of lives across the country. The NHS Long Term Plan set out an ambition that 55,000 more people will survive their cancer – to achieve this the plan also included an ambition to increase the number of cancers diagnosed at stages one and two from half to three-quarters of cancer patients. Cally Palmer, national cancer director at NHS England, said: “Catching more cancers early is a cornerstone of the NHS Long Term Plan to save a further 55,000 lives a year and targeted lung health checks is one of the first projects to roll out following publication. “These new projects will save lives – early diagnosis for cancer is crucial as it is easier to treat, not only saving lives, but it will also mean thousands of patients will avoid life changing treatments.”
The NHS is initially extending the programme to 10 new areas across the country at a cost of around £70 million over four years.
Based on the pioneering schemes in Manchester and Liverpool, the projects will not just identify more cancers quickly but pick up a range of other health conditions including chronic obstructive pulmonary disease (COPD).
The scheme means people aged 55-74 who have been identified as being at increased risk of lung cancer will be invited for a lung health check and be offered a chest scan if appropriate – this scan could take place in a mobile unit or in a hospital setting. The Manchester project scanned 2541 patients and found 65 lung cancers affecting 61 patients. Prior to the study 18% of lung cancers were diagnosed at stage one and 48% stage four. After the study, 68% of lung cancers
NOVEMBER 2019
WWW.CLINICALSERVICESJOURNAL.COM I 51
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104
