1. The lung cancer mortality rate is high, and medical expenses for the treatment of lung cancer are care).. Total number of patients .[r]
(1)1
Can Radiographers Serve as Primary Screeners of Low‐dose Computed Tomography for the
Diagnosis of Lung Cancer?
Presenter
Tomohiro Arai, R.T., Ph.D.,
Email address: depository.of.mail@gmail.com
24th August, 2019: Vietnam Association of Radiological Technologists
To promote the widespread acceptance
Welcome!
Consider the following issues.
To promote the widespread acceptance of low‐dose lung cancer CT screening
1. What is the most effective screening program?
2 H h ld d b d?
Page ・ 2. How should dose be managed?
(2)National medical care expenditures (2011: excluding dental
27,812.9 billion yen
Current status 1: Deaths from lung cancer and medical expenses
The leading cause of death
1. The lung cancer mortality rate is high, and medical expenses for the treatment of lung cancer arecare)
Total number of patients
with malignant neoplasms 1,957,000 patients General medical care
expenditures (for malignant neoplasms)
3,183.1 billion yen
Number of patients with
lung cancer 138,000 patients
Colon
Lung
expenses for the treatment of lung cancer are increasing.
Page ・
Medical care expenditures
for lung cancer 381.1 billion yen Medical care expenditures
for lung cancer (per capita) 2,761,600 yen Medical expense of Early
detection (VATS） 976,263 yen
Breast Prostat e
※ VATS : Video Assisted Thoracic Surgery
if lung cancer can be found at an early stage.
The Accreditation Council recognizes and publicizes medical professionals have specialized education, training and experience related to Lung Cancer CT Screening
Approach of the Accreditation Council for Lung Cancer CT Screening
To guarantee lung cancer CT screening at a certain accuracy or higher at anytime and anywhere in Japan.
Technologies and Abilities required for
Radiological Technologist (RT). Institution
Accredited…
Page ・
RT
Doctor
For the purpose of fostering and producing human resources with skills, the lung cancer CT screening certification mechanism was established ■ Constant quality control of CT
(3)3 Number of certified RT for Lung Cancer CT Screening
Chubu
R.T = 253 Hokkaido & Tohoku
R.T = 127 Kinki
R.T = 317
K & Oki
Kanto R.T = 438
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A total of 1453 Radiological Technologists have been certified “license in low‐ dose lung cancer CT screening” in approximately 10 years based on the test results
Kyusyu & Okinawa R.T = 166
Chugoku & Shikoku R.T = 438
Information
This report was published as an activity of
the Accreditation Council for Lung Cancer CT Screening.
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Publication：Journal of X‐Ray Science and Technology Date ：2018．7.22
(4)受験要項
■ The basic requirements for technologists to perform the examination were licensure and at least years of clinical
Requirements for the exam
examination were licensure and at least 2 years of clinical experience as a radiographer.
• Score of >60% is needed for the written
examination
Criteria of judgment (pass/fail)
Page ・ examination
• Detection sensitivity of "true positive” (TP) must be >0.90
• Az value in the area under the receiver operating characteristic curve of >0.90
Abnormal finding detection test
Large Category Middle Category
1 Basic of CT A Basic of CT scanner B Basic of CT image
Standard questions of written test
2 Management techniques of CT
A Image quality control B Dose management C CT Exposure
3 Inspection technology of lung
A
Basic knowledge of certified technologist of lung cancer CT screening
B Practice of lung cancer CT
Page ・
cancer CT screening B examination g
C Accuracy management of lung cancer CT examination Basic knowledge of chest image
diagnosis
(5)5
Abnormal findings detection method ‐ CT image viewer for test ‐
If lung nodule is identified = TP (True Positive)
× ×
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1 Display slices are changed by scrolling the mouse The mouse is also used to mark the locations showing
abnormal findings.
3 Image data for the next patient is loaded by clicking [Next Patient] after image interpretation for the current patient is completed
If lung nodule is suspected in a region where lung nodule is not present = FP (False Positive)
Overall structure of the abnormal findings detection test system Abnormal findings
detection test
Counting and scoring of test results Clinical images Correct answer
data
Examinees
100 to 150 examinees
Test system Counting system
TP (True Positive) or
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<1> 100 client systems are connected to one server system. <2> Suspicious lung nodules are detected by the examinee.
<3> Counting and analysis are performed immediately after the test is completed.
Test results Countingresults
( )
(6)Result of Written TEST
n s **
n.s.
** : p < 0.01 * : p < 0.05
n.s.: no significant difference
n.s.
Avg. Value
77.1 Avg. Value76.4 Avg. Value
74.2 Avg. Value73.0
Score
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** **
Classification of experience years
n.s. *
n.s. n.s.
Result of Abnormal findings detection test
** : p < 0.01 * : p < 0.05
n.s.: no significant difference
**
Avg. Value 0.922
Avg. Value 0.930
Avg. Value 0.937
Avg. Value 0.937
TP
values
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** **
(7)7 n.s. n.s. ** * Result of Abnormal findings detection test ** : p < 0.01 * : p < 0.05 n.s.: no significant difference Avg. Value
0.465 Avg. Value0.430
Avg. Value 0.484 Avg. Value 0.365 Average number of FP
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** n.s. Classification of experience years Relationship between years of experience and performance of CT used RT acquire reading ability from the work environment • Output only the necessary range using film Transition of business configuration of CT Multi slice CT (64‐row detectors ) (Vol ume of Im age data)
p y y g g
• In single‐slice, once a lesion is recognized on a thick‐slice image, thin‐slice images are obtained again
Multi slice CT (16‐row detectors )
Single Slice CT
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(8)■ From the test analysis of resluts
Witten test
Conclusion
• the written test tended to be higher with less experience.
Abnormal finding detection test
• the abnormal finding detection test improved with the number of years of experience.
■ Future of education system
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■ To maintain the standards of certified RTs, it is necessary to eliminate biases in knowledge by assessing the balance between the foundation and clinical knowledge and to review the educational method. ■ We believe that training and practice with CAD is indispensable to
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