Insights

NOVEMBER 10, 2009

Lung Cancer 2009: Imaging in Lung Cancer Detection and Treatment

Denise R. Aberle, MD & Martin Allen-Auerbach, MD

Two renowned experts from UCLA come together to discuss state-of-the art imaging in the detection and treatment of a very common malignancy, lung cancer. Contemporary imaging techniques have the potential to improve survival and facilitate optimum treatment strategies.  This discussion is useful for individual with cancer as well as those worried about the potential risks of developing it due to exposure to tobacco smoke. Roughly 87% of lung cancers are attributed to cigarette smoking. Although cancer risk is lowered by smoking cessation, the risk is not eliminated, and lung cancer now occurs with equal frequency in current and former smokers.  People exposed to second hand smoke are also at increased risk. One of the major determinates of improved survival in patients with lung cancer is diagnosis at an early stage. There is currently no recommended screening test for the early detection of lung cancer, although the use of computed tomography at low radiation dose is a subject of great interest and controversy. Our current state of knowledge about low dose CT (LDCT) for lung cancer screening is reviewed including the major clinical trials that have contributed to our understanding of LDCT are discussed as well as aspects of the ongoing National Lung Screening Trial--a massive randomized sponsored by the National Cancer Institute clinical trial with over 50,000 participants. The potential benefits of screening and the inherent risks are presented. Once lung cancer is diagnosed, follow-up of the many treatments currently available for patients with all stages of disease is an important strategy to improve patient outcomes. PET/CT can help in assessing the effectiveness of a chosen treatment by non-invasively imaging the changes of uptake of tracers such as FDG into the tumor during and after therapy which helps doctors determine how well a specific therapy is working. Ongoing clinical trials will help to find out how PET/CT can be best applied to tailor treatment of lung cancer for optimal effectiveness.

Denise R. Aberle, MD, is a Professor of Radiology and Bioengineering and the Vice-Chair of Research in the Department of Radiological Sciences, David Geffen School of Medicine at UCLA.  Dr. Aberle’s clinical and research focus is in pulmonary imaging and the use of imaging technologies in lung cancer early diagnosis and treatment. She is a member of the Thoracic Oncology Program of the Jonsson Cancer Center and a collaborator in the UCLA Lung Cancer SPORE (Specialized Project of Research Excellence) funding by the National Cancer Institute. She is also the national Principal Investigator of the National Lung Screening Trial, a large multicenter randomized trial sponsored by the National Cancer Institute that is looking at the benefits of lung cancer screening with chest x-rays versus computed tomography in individuals at high risk.

Martin Allen-Auerbach, MD, is the Director of Nuclear Medicine at the Santa Monica UCLA Hospital, and Assistant Professor in Nuclear Medicine, Division of Pharmacology, at the David Geffen School of Medicine at UCLA. Dr. Allen-Auerbach has published both basic and clinical research focused on optimizing PET/CT imaging strategies in various cancers, the clinical evaluation of new PET tracers and the advantages of PET/CT over other imaging modalities when it comes to staging and assessment of treatment response in malignant disease. Apart from conducting several clinical studies, he serves as an attending physician for the Departments of Nuclear Medicine both at the Westwood and Santa Monica Hospital.