Title: Low Dose Computed Tomography (LDCT) Versus Chest X-ray in Chronic Smokers- Can LDCT be Used as a Motivation to Quit Smoking?
Authors: Dr Tosha Jatin Desai, Dr Ekta Vinubhai Vadher, Dr Nandini Umesh Bahri
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.60
Abstract
Background- Smoking is one of the biggest health threats to mankind. Early diagnosis of pulmonary changes induced by smoking can help in timely intervention and prediction of course of smoking-induced diseases.
Aim-The aim of this study was to determine the relative prevalence of various common radiological findings associated with smoking and compare their detection on digital chest X-ray and Low Dose Computed Tomography (LDCT)
Materials and Methods-Chest X-ray PA view and LDCT scan of 50 chronic symptomatic/asymptomatic male smokers were analysed over a period of 1 year from February 2016 to February 2017.
Summary- Chest X-ray was less sensitive in detecting early emphysematous changes, small pulmonary nodules and minimal fibro-bronchieactatic changes. In our study, spectrum of respiratory findings in smokers on LDCT included bronchial thickening (68%) emphysema (66%), interstitial thickening (61%), pulmonary micro- and macro- nodules, air space opacification, bronchieactasis, mediastinal lymphadenopathy and ground-glass opacities. The sensitivity of LDCT in diagnosing malignant lesions was 88.4% and speceficity was 82.5%. The sensitivity of Chest Xray in diagnosing malignant lesions was 50% and specificity was 87.5%.
Conclusion- LDCT diagnoses malignant lesions much earlier and provides a better graphical picture of the pathology under study to young and middle aged smokers willing to quit smoking. Since the baseline risk of lung cancer development is small and the dose exposure in a single LDCT scan is well below the annual adult radiation dose limit, the risk-benift ratio is very favourable.
Keywords-smoking, smoking-induced diseases, Chest X-ray, LDCT, risk-benifit ratio.
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