Review

. 2025 May 2:220:115323.

doi: 10.1016/j.ejca.2025.115323. Epub 2025 Feb 22.

Action plan for an international imaging framework for implementation of global low-dose CT screening for lung cancer

Harriet L Lancaster¹, Anna N H Walstra², Kyle Myers³, Ricardo S Avila⁴, Jan Willem C Gratama⁵, Marjolein A Heuvelmans⁶, Sean B Fain⁷, David A Clunie⁸, Ella A Kazerooni⁹, Maryellen L Giger¹⁰, Anthony P Reeves¹¹, Jens Vogel-Claussen¹², Harry de Koning¹³, Rowena Yip¹⁴, Luis M Seijo¹⁵, John K Field¹⁶, James L Mulshine¹⁷, Mario Silva¹⁸, David F Yankelevitz¹⁴, Claudia I Henschke¹⁴, Matthijs Oudkerk¹⁹

Affiliations

¹ University of Groningen, University Medical Center Groningen, Department of Epidemiology, the Netherlands; Institute for Diagnostic Accuracy, Groningen, the Netherlands.
² Institute for Diagnostic Accuracy, Groningen, the Netherlands.
³ Hagler Institute for Advanced Study, Texas A&M University, College Station, Texas, USA.
⁴ Accumetra, Clifton Park, New York, USA.
⁵ Department of Radiology and Nuclear Medicine, Gelre Hospitals, Apeldoorn, the Netherlands.
⁶ University of Groningen, University Medical Center Groningen, Department of Epidemiology, the Netherlands; Institute for Diagnostic Accuracy, Groningen, the Netherlands; Department of Respiratory Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands.
⁷ Department of Radiology, University of Iowa, Iowa City, IA, USA.
⁸ PixelMed Publishing, Bangor, PA, USA.
⁹ Department of Radiology, Michigan Medicine/University of Michigan, Ann Arbor, MI, USA.
¹⁰ Department of Radiology, University of Chicago, Chicago, IL, USA.
¹¹ School of Electrical and Computer Engineering, Cornell University, Ithaca, NY, USA.
¹² Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
¹³ Department of Public Health, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands.
¹⁴ Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
¹⁵ Department of Respiratory Medicine, Clínica Universidad de Navarra, Madrid 31008, Spain.
¹⁶ Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
¹⁷ Department of Internal Medicine, Graduate College, Rush University Medical Center, Chicago, IL, USA.
¹⁸ Scienze Radiologische, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy; Department of Radiology, University of Massachusetts Memorial Health, University of Massachusetts, Chan Medical School, Worcester, MA, USA.
¹⁹ Institute for Diagnostic Accuracy, Groningen, the Netherlands; Faculty of Medical Sciences, University of Groningen, Groningen, the Netherlands. Electronic address: m.oudkerk@rug.nl.

PMID: 40022837
DOI: 10.1016/j.ejca.2025.115323

Free article

Review

Action plan for an international imaging framework for implementation of global low-dose CT screening for lung cancer

Harriet L Lancaster et al. Eur J Cancer. 2025.

Free article

. 2025 May 2:220:115323.

doi: 10.1016/j.ejca.2025.115323. Epub 2025 Feb 22.

Authors

Affiliations

¹ University of Groningen, University Medical Center Groningen, Department of Epidemiology, the Netherlands; Institute for Diagnostic Accuracy, Groningen, the Netherlands.
² Institute for Diagnostic Accuracy, Groningen, the Netherlands.
³ Hagler Institute for Advanced Study, Texas A&M University, College Station, Texas, USA.
⁴ Accumetra, Clifton Park, New York, USA.
⁵ Department of Radiology and Nuclear Medicine, Gelre Hospitals, Apeldoorn, the Netherlands.
⁶ University of Groningen, University Medical Center Groningen, Department of Epidemiology, the Netherlands; Institute for Diagnostic Accuracy, Groningen, the Netherlands; Department of Respiratory Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands.
⁷ Department of Radiology, University of Iowa, Iowa City, IA, USA.
⁸ PixelMed Publishing, Bangor, PA, USA.
⁹ Department of Radiology, Michigan Medicine/University of Michigan, Ann Arbor, MI, USA.
¹⁰ Department of Radiology, University of Chicago, Chicago, IL, USA.
¹¹ School of Electrical and Computer Engineering, Cornell University, Ithaca, NY, USA.
¹² Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
¹³ Department of Public Health, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands.
¹⁴ Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
¹⁵ Department of Respiratory Medicine, Clínica Universidad de Navarra, Madrid 31008, Spain.
¹⁶ Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
¹⁷ Department of Internal Medicine, Graduate College, Rush University Medical Center, Chicago, IL, USA.
¹⁸ Scienze Radiologische, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy; Department of Radiology, University of Massachusetts Memorial Health, University of Massachusetts, Chan Medical School, Worcester, MA, USA.
¹⁹ Institute for Diagnostic Accuracy, Groningen, the Netherlands; Faculty of Medical Sciences, University of Groningen, Groningen, the Netherlands. Electronic address: m.oudkerk@rug.nl.

PMID: 40022837
DOI: 10.1016/j.ejca.2025.115323

Abstract

Reduction in lung cancer mortality is achievable through low dose computed tomography (LDCT) screening in high-risk individuals. Many countries are progressing from local LDCT screening studies to national screening programs. Implementation of effective large-scale screening programs is complex and requires a multi-disciplinary approach. A recent overview of the technical aspects of implementing high quality LDCT for screening resulted from the inaugural international expert meeting of the Alliance for Global Implementation of Lung and Cardiac Early Disease Detection and Treatment (AGILE). This covers the most important aspects of the CT imaging process: standardisation in CT image acquisition and interpretation, CT protocol management, technology developments and minimal requirements, integration of lung cancer biomarkers, and the role of AI in CT lung nodule detection, segmentation, and classification, and related data security issues.

Keywords: Artificial intelligence; Biomarkers; Early detection; LDCT; Lung cancer; Lung nodule; Screening.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. M. Giger is contact PI for MIDRC and is on the editorial board for SPIE Journal of Medical Imaging. Dr. S. Fain serves as a scientific advisor for Polarean LLC. Dr. S. Fain also receives research funding from Polarean LLC, Siemens Healthineers INC, and GE Healthcare INC for development of pulmonary CT and MRI methods. Dr. K. Myers serves as a scientific and regulatory consultant for MIDRC, RevealDx, Annalise, and the I-ELCAP AIRS project funded by the Simons Foundation. All other authors have no competing interests to declare

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Action plan for an international imaging framework for implementation of global low-dose CT screening for lung cancer

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Action plan for an international imaging framework for implementation of global low-dose CT screening for lung cancer

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