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Cleveland Clinic leads clinical programme to detect early-stage lung cancers

Cleveland Clinic : 27 November, 2007  (New Product)
Cleveland Clinic and Riverain Medical have established the first study in a programme to determine whether chest X-ray CAD (computer-aided detection) can improve practical early detection of lung cancer.
The programme is designed to determine whether chest X-ray CAD can help identify hard to detect lung cancers at an early stage when they are most treatable, leading to improved patient survival rates.

'Developing early detection methods is a key to improving treatment of lung cancer,' said Micheal Phillips, MD, section head of imaging sciences in Cleveland Clinic's Department of Diagnostic Radiology. 'As it stands now, treatment options are limited because identifying malignant lung tumours in their early stage is so difficult.'

The evaluation of X-ray CAD is being funded by a grant from the State of Ohio. Moulay Meziane, MD, is the principal investigator for the five-year study that will involve 9,000 test subjects. Investigators are currently conducting retrospective studies to evaluate the performance of the CAD system and the readers using it. The participants for the clinical trial will be enrolled in early 2008.

In previous clinical trials, Riverain's chest X-ray CAD technology helped radiologists identify 16 percent more 9 to 15mm solitary pulmonary nodules that were early stage (1A) lung cancer than the radiologist would have otherwise detected without CAD. OnGuard is the only FDA-PMA approved chest X-ray CAD product on the market.

'Unfortunately, most lung cancers are diagnosed too late for treatment to potentially save lives,' said Sam Finkelstein, president of Riverain Medical. 'We believe that OnGuard can significantly improve clinicians' ability to identify lung cancers early and have a positive impact on the rate of patient survival which amazingly hasn't improved in over 40 years.'

The Cleveland Clinic Foundation and Riverain Medical, along with Wright State University and University Hospitals Health System, have joined together to form the Early Lung Disease Detection Alliance (ELDDA), a multidisciplinary research and commercialisation programme that will develop, test (through clinical trials), and bring to market new image-analysis systems that permit the early detection of lung cancer and other lung diseases.

This computer-aided detection (CAD) system will be applied to the most widely available and used imaging exam, the chest x-ray.

The goal is to not only advance the early detection of lung cancer and other diseases but also accelerate the commercialisation of computer-aided detection, image interpretation, and multidisciplinary applications of computer science and medical diagnostics.

The current retrospective study is a multiple-reader multiple-cases study involving six expert chest radiologists, six general radiologists, and six pulmonologists to assess the usefulness of CAD. Each reader will read 200 cases of suspected lung cancer of which about 100 had cancer and 100 did not. All cases were CT confirmed. All cancers are biopsy or surgically confirmed.

The study is expected to be completed by the end of the year. Investigators from Cleveland Clinic include Dr Phillips, Moulay Meziane, MD, Section Head of Chest Imaging, Peter Mazzone, MD, Staff Pulmonary Medicine and Nancy Obuchowski, PhD, vice chair, Department of Quantitative Health Services.

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