Lung cancer imaging methods in China from 2005 to 2014: A national, multicenter study

Abstract

Background: The study was conducted to examine changes in diagnostic and staging imaging methods for lung cancer in China over a 10-year period and to determine the relationships between such changes and socioeconomic development.

Methods: This was a hospital-based, nationwide, multicenter retrospective study of primary lung cancer cases. The data were extracted from the 10-year primary lung cancer databases at eight tertiary hospitals from various geographic areas in China. The chi-squared test was used to assess the differences and the Cochran-Armitage trend test was used to estimate the trends of changes.

Results: A total of 7184 lung cancer cases were analyzed. Over the 10-year period, the utilization ratio of diagnostic imaging methods, such as chest computed tomography (CT) and chest magnetic resonance imaging (MRI), increased from 65.79% to 81.42% and from 0.73% to 1.96%, respectively, while the utilization ratio of chest X-ray declined from 50.15% to 30.93%. Staging imaging methods, such as positron emission tomography-CT, neck ultrasound, brain MRI, bone scintigraphy, and bone MRI increased from 0.73% to 9.29%, 22.95% to 47.92%, 8.77% to 40.71%, 42.40% to 62.22%, and 0.88% to 4.65%, respectively; abdominal ultrasound declined from 83.33% to 59.9%. These trends were more notable in less developed areas than in areas with substantial economic development.

Conclusion: Overall, chest CT was the most common radiological diagnostic method for lung cancer in China. Imaging methods for lung cancer tend to be used in a diverse, rational, and regionally balanced manner.

Keywords: China; imaging method; lung cancer; trend.

Figure 1

Trends in the utilization ratios of different imaging methods from 2005 to 2014. (a) Chest X‐ray, (b) chest computed tomography (CT), (c) positron emission tomography (PET)‐CT, (d) chest magnetic resonance imaging (MRI), (e) abdominal ultrasound, (f) neck ultrasound, (g) brain CT, (h) brain MRI, (i) bone MRI, and (j) bone scintigraphy. Note: P_trend of the utilization ratio of chest MRI in high economic areas = 0.23, P_trend of the utilization ratio of brain CT in low economic areas = 0.05, P_trend of the utilization ratio of bone MRI in high economic areas = 0.13, all others P_trend < 0.05. () Nationwide, () high economic level areas, and () low high economic level areas.