The Robert H. Lurie Comprehensive Cancer Center of northwestern university at northwestern Memorial Hospital

Advancements in Early Detection
The earlier lung cancer is found, the better the 
patient’s chance of survival. But chest X-rays, the 
most common type of screenings, have not shown
a proven benefit in reducing deaths by detecting 
tumors early. The National Lung Cancer Screening 
Trial (NLST), concluded in 2011, is the first scientific 
study to provide clear evidence that another type
of scan, the low-dose helical CT, is effective in 
significantly reducing deaths in adults who are or 
have been heavy smokers. Data from the NLST,
a randomized clinical trial with more than 53,000 
participants at 33 sites nationally, showed 20 
percent fewer deaths among those screened with
a low-dose helical CT scan compared with chest 
X-ray, says Eric M. Hart, MD, radiologist on the 
medical staff at Northwestern Memorial and 
associate professor of Radiology at Feinberg.
“For the first time we’ve shown that we can reduce 
deaths from lung cancer by actively trying to find it,” 
says Dr. Hart, the principal investigator here, the only 
NLST site in Chicago. “A lot of people are working
on improved therapy. Until we have that, this is our 
best bet for reducing deaths from lung cancer.”
Brian L. Hitsman, PhD
Eric M. Hart, MD

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Diagnosis
Patients with scans showing an indeterminate or 
suspicious lymph node or nodule in the chest are 
referred to the Northwestern Pulmonary Nodule 
Clinic, where physicians determine whether a 
diagnostic procedure is warranted, says Colin T. 
Gillespie, MD, inaugural director of Interventional 
Pulmonary Medicine at Northwestern Memorial 
and assistant professor of Medicine at Feinberg, 
who oversees the clinic. For diagnosis and 
staging, interventional pulmonologists use 
advanced technologies such as endobronchial 
ultrasound, performed by inserting a 
bronchoscope through the nose or mouth to 
survey the area between the lungs, then biopsy 
the lymph nodes there. Radial probe ultrasound 
is used to biopsy nodules that are farther out 
than a bronchoscope can reach. According to
Dr. Gillespie, both techniques are precise, 
minimally invasive outpatient procedures, 
considered safer than surgical and transthoracic 
biopsies. “By improving our ability to localize
and biopsy the lesions from inside, our risk of 
complication drops.”