Artificial intelligence (AI) is more than twice as good as radiologists alone at screening patients for lung cancer, according to new research.
In a real-world setting, machine learning-based software significantly boosted the identification of lung nodules on chest X-rays.
The technique is more sensitive and less likely to miss cases that need immediate treatment. It could improve survival rates for one of the deadliest forms of the disease.
The abnormal growths commonly form after infections. In some cases, they can be a sign of cancer.
It comes after a new trial in the UK found that AI technology could also detect bowel cancer cases that humans miss. Lung and bowel cancers are among the most common cancers in the United States.
The above scan is from a patient in the trial. On the left, the scan looked at by doctors is shown with an arrow pointing to the lung nodule diagnosed as cancer. On the right, the scan fed into the AI is shown with the green dot over the same lung nodule. The dot indicates that the machine has detected a nodule that should be checked for cancer
Co-author Dr Jin Mo Goo, of Seoul National University Hospital, said: ‘Detecting lung nodules, a primary finding of lung cancer, is one of the crucial tasks in chest X-rays.
‘Many studies have suggested AI-based computer-aided detection software can improve radiologists’ performance, but it is not widely used.’
Lung cancer is too often diagnosed after it has spread owing to there being few initial symptoms.
An estimated 238,340 people will be diagnosed with lung cancer in 2023 in the US, although this is trending downwards — likely driven by fewer people smoking.
Approximately 127,070 American lives are lost to the disease annually.
For the study, researchers included 10,476 patients, who underwent chest X-rays at a screening center between June 2020 and December 2021.
Dr Goo said: ‘As our trial was conducted with a pragmatic approach, almost all enrolled participants were included, which is a real clinical setting.’
It took into account age, sex and past history of lung cancer. One in nine (11 percent) were current or former smokers.
The participants were randomly and evenly divided into two groups – AI or not-AI. The first group’s X-rays were analyzed by one of three radiologists using AI, while the second group’s were interpreted without the technology.
In 0.59 percent of cases, lung nodules requiring action were detected using AI — compared to 0.25 percent of the others whose images were reviewed only by radiologists.
Overall, lung nodules were identified in two percent of the patients.
Dr Goo said: ‘Our study provided strong evidence that AI could really help in interpreting chest radiography.
‘This will contribute to identifying chest diseases, especially lung cancer, more effectively at an earlier stage.’
The results, published in Radiology, also suggested AI works consistently across different populations – even for those with diseased or postoperative lungs.
AI has previously been shown to help predict several cancers including breast cancer, as well as bowel diseases, Alzheimer’s, heart attacks and dementia.
WHAT IS LUNG CANCER?
Lung cancer is one of the most common and serious types of cancer.
Around 47,000 people are diagnosed with the condition every year in the UK.
There are usually no signs or symptoms in the early stages of lung cancer, but many people with the condition eventually develop symptoms including:
- A persistent cough;
- Coughing up blood;
- Persistent breathlessness;
- Unexplained tiredness and weight loss;
- An ache or pain when breathing or coughing;
- You should see a doctor if you have these symptoms.
Types of lung cancer
There are two main forms of primary lung cancer. These are classified by the type of cells in which the cancer starts growing. The types are:
- Non-small-cell lung cancer. The most common form, accounting for more than 87 percent of cases;
- Small-cell lung cancer – a less common form that usually spreads faster than non-small-cell lung cancer.
Lung cancer patients
Lung cancer mainly affects older people. It’s rare in people younger than 40.
More than four out of 10 people diagnosed with lung cancer in the UK are aged 75 and older.
Although people who have never smoked can develop lung cancer, smoking is the most common cause (accounting for about 72 percent of cases).
This is because smoking involves regularly inhaling a number of different toxic substances.
How is lung cancer diagnosed?
Patients are checked for lung cancer via three techniques. The first is taking an X-ray of the lungs, and checking this to reveal any abnormal masses or nodules. A CT scan could also be used to check for lesions an X-ray may not detect.
If a patient is coughing up blood, then this can also be checked for lung cancer cells. Doctors will look at the liquid under a microscope to detect the cancerous cells.
If cancer is suspected, a biopsy may be performed. This is where some cells from an abnormal mass in the lungs are removed and tested for cancer.
Treatments for the disease
Treatment depends on the type of mutation the cancer has, how far it’s spread and how good your general health is.
If the condition is diagnosed early and the cancerous cells are confined to a small area, surgery to remove the affected area of the lung may be recommended.
If surgery is unsuitable due to your general health, radiotherapy to destroy the cancerous cells may be recommended instead.
If the cancer has spread too far for surgery or radiotherapy to be effective, chemotherapy is usually used.
There are also a number of medicines known as targeted therapies.
They target a specific change in or around the cancer cells that is helping them to grow.
Targeted therapies cannot cure lung cancer but they can slow its spread.