Emerging Approaches to Complement Low-Dose Computerized Tomography for Lung Cancer Screening: A Narrative Review

Area of Science:

• Oncology and Radiology
• Biomarker Discovery
• Medical Diagnostics

Background:

• Low-dose computed tomography (LDCT) is vital for lung cancer screening but has limitations in accuracy.
• Inaccurate screening leads to unnecessary invasive procedures and delayed treatment.
• Enhancing LDCT accuracy is essential for improved patient outcomes.

Purpose of the Study:

• To review emerging modalities for improving lung cancer screening accuracy.
• To evaluate the principles, advantages, and disadvantages of radiomics, breath, urine, and blood tests.
• To assess the potential clinical utility of these novel approaches.

Main Methods:

• Comprehensive literature search using PubMed and Google Scholar.
• Identification and analysis of four key emerging approaches: radiomics, breath analysis, urine tests, and blood tests.
• Evaluation of each modality's potential, limitations, and validation status.

Main Results:

• Radiomics shows potential but lacks adequate validation.
• Breath and urine tests are noninvasive but susceptible to confounding factors.
• Blood tests (e.g., Galleri®) offer high specificity but low sensitivity for early-stage disease.
• Significant cost is a consideration for mass public implementation.

Conclusions:

• Blood tests demonstrate potential clinical utility, particularly for ruling in malignancy.
• Further well-designed clinical trials are necessary to establish the utility of blood tests in lung cancer screening.
• Emerging technologies require rigorous validation before widespread adoption in clinical practice.