Asbestos Surveillance Program Aachen (ASPA): initial results from baseline screening for lung cancer in asbestos-exposed high-risk individuals using low-dose multidetector-row CT

Eur Radiol. 2007 May;17(5):1193-9. doi: 10.1007/s00330-006-0426-8. Epub 2006 Sep 20.


The purpose of this study was to assess the prevalence of lung cancer in a high-risk asbestos-exposed cohort using low-dose MDCT. Of a population of 5,389 former power-plant workers, 316 were characterized as individuals at highest risk for lung cancer according to a lung-cancer risk model including age, asbestos exposure and smoking habits. Of these 316, 187 (mean age: 66.6 years) individuals were included in a prospective trial. Mean asbestos exposure time was 29.65 years and 89% were smokers. Screening was performed on a 16-slice MDCT (Siemens) with low-dose technique (10/20 mAs(eff.); 1 mm/0.5 mm increment). In addition to soft copy PACS reading analysis on a workstation with a dedicated lung analysis software (LungCARE; Siemens) was performed. One strongly suspicious mass and eight cases of histologically proven lung cancer were found plus 491 additional pulmonary nodules (average volume: 40.72 ml, average diameter 4.62 mm). Asbestos-related changes (pleural plaques, fibrosis) were visible in 80 individuals. Lung cancer screening in this high-risk cohort showed a prevalence of lung cancer of 4.28% (8/187) at baseline screening with an additional large number of indeterminate pulmonary nodules. Low-dose MDCT proved to be feasible in this highly selected population.

MeSH terms

  • Aged
  • Asbestosis / diagnostic imaging*
  • Asbestosis / epidemiology
  • Germany / epidemiology
  • Humans
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / epidemiology
  • Male
  • Mesothelioma / diagnostic imaging*
  • Mesothelioma / epidemiology
  • Occupational Exposure / adverse effects*
  • Population Surveillance
  • Power Plants
  • Prevalence
  • Prospective Studies
  • Radiographic Image Interpretation, Computer-Assisted
  • Risk Assessment
  • Risk Factors
  • Software
  • Time Factors
  • Tomography, X-Ray Computed / methods*