Follow up and Additional Testing
At this point in time, if the initial screening is normal, we usually recommend that high-risk individuals consider annual low-dose CT screening until age 74. If a nodule is detected on your Screening CT, closer follow up or additional testing may be required. All follow-up testing can be performed at NYULMC, and the Lung Screening Team will assist you through further testing or treatment. Follow up tests may be covered by your insurance company.
Should cancer be suspected, our team of expert pulmonologists, surgeons, oncologists, and other professionals are available to guide you through the process.
Abnormalities are frequently found on screening CT’s, especially in individuals who smoke. The NLST found that almost 40% of participants had an abnormality requiring follow-up on one of their scans. More than 96% of these turned out to be minor benign abnormalities, not cancer.
In most cases, the only additional tests necessary are follow-up low-dose CT scans, to confirm that the findings on the scan are unchanged over time. In some cases, a course of antibiotics may be recommended if the findings appear to be related to infection or inflammation in the lungs.
Positron Emission Tomography (PET)-CT
Depending on the results of your CT scan, we may recommend an alternative follow-up scan called a PET-CT scan. This study provides information about the metabolic activity of the lesion found on your CT scan, which can indicate the likelihood that it is or is not cancer. PET-CTs are nuclear medicine studies combined with CT, which provide images of the entire body using a tracer that you swallow.
if the follow-up CT shows a lesion has increased in size, or the PET scan shows high activity, we may recommend a biopsy. This can be done by fine needle aspiration by the radiologist while you are in the CT scanner, or a pulmonologist may perform a bronchoscopy to obtain a sample from inside the lungs. The Lung Screening team will assist you in promptly scheduling these procedures.