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Chest CT Scan: The Role of Imaging in Preventing Pulmonary and Cardiovascular Diseases

Chest CT (or thoracic computed tomography) has become an essential diagnostic tool. Lung cancer, cardiovascular disease, mediastinal disorders... thoracic imaging allows for the early identification of many potentially serious pathologies. The combination of low-dose technologies and artificial intelligence makes it possible to detect abnormalities at the earliest stages of tissue changes, well before the appearance of clinical symptoms.

Health issues

Lung and cardiovascular diseases represent a major health challenge today, both globally and nationally. According to the latest data published by the World Health Organization (WHO), cardiovascular diseases remain the leading cause of mortality worldwide, with approximately 17.9 million deaths each year, or nearly 32% of all deaths recorded worldwide. Chronic lung diseases and lung cancer are also among the leading causes of mortality and morbidity, affecting millions of people each year and putting increasing pressure on healthcare systems across the globe.

Switzerland is not immune to this problem. According to recent statistics from the Federal Office of Public Health (FOPH), cardiovascular disease remains the leading cause of death in our country, with nearly 20,000 deaths annually, representing approximately one-third of all recorded deaths. Furthermore, lung cancer is of particular concern: each year, nearly 4,500 new cases are diagnosed, making it one of the most common and deadly cancers in Switzerland. The Swiss Lung League also points out that the majority of cases are diagnosed late, thus significantly reducing the chances of curative treatment.

Faced with these major challenges, the implementation of innovative, precise, and less invasive diagnostic tools has become a priority. Low-dose chest CT, thanks to its advanced medical imaging capabilities, is now positioned as a key player in the early detection of pulmonary and cardiovascular diseases. Its regular and targeted use could considerably reduce medical complications related to these pathologies, thereby significantly improving the quality of life and prognosis of the patients concerned.

Why prescribe a chest CT scan?

Chest CT scans allow for the exploration of all pulmonary, vascular, and mediastinal structures with unparalleled precision. In Switzerland, its main indications are:

  • Early screening for lung cancer, particularly in smokers and ex-smokers, in accordance with the recommendations of the Swiss Lung League.
  • Monitoring of already identified pulmonary nodules, ensuring precise follow-up to detect any suspicious developments early.
  • Exploration of thoracic vascular pathologies such as pulmonary embolisms, aneurysms or aortic dissections, allowing rapid and targeted intervention.
  • Evaluation of the mediastinum, to clearly identify lymph nodes, masses or cysts that may require specific management.
  • The pre-operative cardiothoracic assessment, essential before any major surgical intervention, to ensure patient safety.
  • Post-therapeutic monitoring of patients operated on or treated for thoracic pathologies, guaranteeing appropriate monitoring and prevention of complications or recurrences.

Low-dose chest CT is therefore a high-performance medical examination that allows early and accurate detection of several major chest pathologies. It is particularly effective for:

  • Lung cancer: Early detection of pulmonary nodules, even very small ones, promoting curative treatment before they spread.
  • Pulmonary embolism: Rapid diagnosis of a life-threatening emergency caused by a blood clot, essential for immediate treatment.
  • Cardiovascular diseases: Accurate assessment of coronary calcium, an indicator of the risk of heart attack and other coronary diseases, allowing effective prevention.
  • Chronic lung diseases (COPD, emphysema): Precise visualization of lung lesions to adapt medical monitoring and optimize treatments.
These pathologies require special attention given their severity and their potential impact on patients' quality of life. Low-dose chest CT scanning represents a major advance in optimizing their prevention, diagnosis, and management.

The advantages of low-dose CT scanning

Long limited by concerns about radiation exposure, chest CT scanning has evolved considerably with the arrival of high-performance low-dose technologies. Today, these technical advances make it possible to drastically reduce radiation exposure while maintaining exceptional image quality, essential for accurate diagnosis:
  • Low radiation exposure, less than 1 mSv for screening examinations, which is well below the levels observed with conventional scanners, thus minimizing the risks associated with repeated irradiation.
  • Optimized image quality thanks to modern iterative reconstruction methods, allowing to improve the sharpness and precision of the images obtained while limiting exposure.
  • A quick, painless, and non-invasive examination, which significantly improves patient comfort during the procedure. The short duration of the examination also promotes better patient acceptance, which is particularly important in the context of regular screening.

These benefits make low-dose chest CT a tool of choice not only for the early detection of serious pathologies but also for optimal regular monitoring of patients at risk or already diagnosed.

The contribution of artificial intelligence: towards augmented analysis

Artificial intelligence (AI) is revolutionizing the field of medical imaging, particularly in thoracic imaging. At the Lausanne Imaging and Diagnostic Center (CID), AI is now an integral part of the diagnostic process, revolutionizing the way examinations are analyzed and interpreted:
  • Automated image sorting and pre-analysis: AI immediately and accurately detects lung nodules, including very small ones, significantly increasing the chances of early detection.
  • Accurate quantification of lesions: AI precisely measures the size, volume and evolution of lesions over successive examinations, thus facilitating rigorous and personalized medical monitoring.
  • Assisting radiologists in prioritizing high-risk cases: AI systems provide radiologists with clear and accurate information on potentially serious abnormalities, enabling rapid and targeted care.

By integrating AI into the diagnostic process, the accuracy, sensitivity, and safety of thoracic diagnostics are significantly enhanced. Radiologists retain a central role, overseeing and validating all analyses, but are now assisted by cutting-edge technological tools that improve the quality of the overall diagnosis and enable even more efficient patient care.

How does the exam take place?

The chest CT scan is designed to be simple, quick, and comfortable for the patient. Its procedure is optimized to minimize stress and logistical constraints:

  • No special preparation is necessary : ​​The patient can eat, drink and take their usual medication before the examination, unless specifically indicated.
  • Short average duration: Image acquisition generally lasts between 5 and 10 minutes, which allows for rapid treatment, even on an outpatient basis.
  • Contrast injection only if necessary: ​​In the majority of low-dose screening examinations, no injection is required. In cases of suspected pulmonary embolism or complex vascular exploration, an iodinated contrast agent may be administered.
  • Maximum comfort: The exam is painless and non-invasive. The patient lies comfortably on the examination table and simply follows the technician's breathing instructions.
  • Rapid transmission of results: Images are immediately analyzed by specialized radiologists at CID Lausanne. A detailed report is quickly transmitted to the family doctor or prescribing specialist, thus ensuring rapid and coordinated clinical care.

A concrete clinical example

At the Lausanne Imaging and Diagnostic Center, the patient pathway has been designed to adapt to each clinical profile, ensuring personalized and effective care.

Let's take the example of Mrs. S., 62 years old, ex-smoker (35 pack-years) , asymptomatic but anxious about her risk of lung cancer. Based on the recommendations of the Swiss Lung League, her family doctor prescribes a low-dose chest CT scan. The appointment is scheduled within a few days. After a warm welcome at the CID, the examination is performed in less than 10 minutes. Artificial intelligence identifies a 5 mm nodule, stable at the check-up 6 months later. Structured follow-up is established, thus avoiding unnecessary anxiety-inducing monitoring while ensuring optimal vigilance.

Another case, Mr. D., 48 years old, active, non-smoker, but consulting in emergency for sudden chest pain . His doctor suspects a pulmonary embolism. A chest CT scan with contrast is performed immediately at the CID. Thanks to the automated analysis assisted by AI, the diagnosis of pulmonary embolism is confirmed and the patient is referred to specialized hospital care without delay.

Finally, Mrs. L., 70 years old, with a history of cardiac surgery , underwent a preoperative CT scan before a new scheduled intervention. The imaging revealed extensive coronary calcification, allowing the anesthetic and surgical strategy to be safely adapted.

Each patient thus benefits from cutting-edge diagnostic expertise, combining latest-generation technology, artificial intelligence and rigorous human validation by radiologists at CID Lausanne.

Precise epidemiological data (in Switzerland and worldwide)

According to recent data from the GLOBOCAN 2020 global registry, lung cancer remains the leading cause of cancer death worldwide, with 2.2 million new cases diagnosed each year and 1.8 million deaths. In Europe, statistics from the European Cancer Information System (ECIS) confirm this alarming trend, with a persistently high incidence, particularly among the elderly and smoking populations.

In Switzerland, the figures are equally worrying. According to the Federal Statistical Office (FSO), approximately 4,500 new cases of lung cancer are diagnosed each year, representing one of the leading causes of cancer death in both men and women. The 5-year survival rate unfortunately remains low, around 20%, due to the often late diagnosis.

Cardiovascular diseases, for their part, remain the leading cause of mortality in Switzerland. The FOPH reports nearly 20,000 deaths annually attributed to heart and vascular conditions. Coronary atherosclerosis and myocardial infarctions account for a significant proportion of these. Furthermore, the prevalence of pulmonary embolism in Switzerland is estimated at between 60 and 70 cases per 100,000 inhabitants each year.

These data confirm the crucial importance of early detection: by identifying lesions at an early stage, low-dose chest CT directly contributes to improving the prognosis of many

Reference scientific studies: international validation of low-dose chest CT

Several large international studies have demonstrated the effectiveness of low-dose chest CT screening in preventing lung cancer and reducing mortality:
  • NLST (National Lung Screening Trial, USA, 2011) : This landmark study of over 53,000 high-risk participants showed a 20% reduction in lung cancer mortality and a 7% reduction in overall mortality with low-dose CT screening compared to chest X-rays.
  • NELSON (Dutch-Belgian Randomized Lung Cancer Screening Trial, Europe, 2020): Involving more than 15,000 participants, this European study confirmed a 24-26% reduction in lung cancer mortality in men and up to 39-61% in women screened by low-dose CT.
  • USPSTF (US Preventive Services Task Force, 2021) : Based on the results of large studies, this institution recommends annual screening with low-dose chest CT in adults aged 50 to 80 years with a significant smoking history.
  • ESMO (European Society for Medical Oncology, 2023) : ESMO now includes in its recommendations the use of low-dose chest CT for the early detection of lung cancer in at-risk populations, confirming the major impact of the results from NLST and NELSON.

All of this robust and consistent scientific data fully justifies the progressive implementation of targeted screening programs, even in Switzerland, in line with the recommendations of the Swiss Lung League and the federal health authorities.

Innovation and future prospects

Thoracic imaging is undergoing a technological evolution, opening up major opportunities for innovation in the years to come. Future advances will include:
  • The continuous improvement of artificial intelligence algorithms, capable not only of detecting, but of predictively interpreting the evolving behavior of pulmonary nodules or coronary calcifications.
  • The development of personalized screening, integrating genetic factors, blood biomarkers and the patient's individual risk profile, making it possible to target the populations to be monitored even more precisely.
  • Further reduction of radiation doses, with ultra-low dose or photon-counting imaging techniques, providing ever higher image quality with minimal exposure.
  • The integration of centralized longitudinal monitoring platforms, allowing medical teams to track the progress of each patient over several years via secure and interoperable databases, thus strengthening the continuum of care.
  • Advanced automation of radiology workflows, streamlining interpretation times and facilitating multidisciplinary coordination between radiologists, pulmonologists, oncologists and cardiologists.

These innovations will provide Swiss patients with increasingly reliable, rapid, and personalized diagnostic tools. The Lausanne CID is fully committed to this dynamic, continuously acquiring the latest technologies and participating in research and innovation networks in advanced thoracic imaging.

The differentiating assets of the Lausanne CID

The Lausanne Imaging and Diagnostic Center offers unique expertise in French-speaking Switzerland in preventive and diagnostic thoracic imaging:

  • Cutting-edge technology : latest-generation low-dose scanners and advanced artificial intelligence systems integrated into daily life.
  • Fast and flexible access : optimized appointment times, urgent care possible for vital indications.
  • Specialized multidisciplinary team : FMH radiologists experienced in thoracic imaging, working closely with pulmonologists, cardiologists and thoracic surgeons in the region.
  • Personalized patient journey : human welcome, individualized monitoring, active coordination with treating physicians.
  • Certified Swiss quality : strict compliance with radiation protection standards, LaMal compliance, alignment with the recommendations of the Swiss Lung League and the FOPH.
  • Constant commitment to innovation : participation in research projects, continuous training of teams and permanent investment in new intelligent imaging solutions.

This combination of human expertise, latest generation technologies and commitment to quality positions the CID Lausanne as a key player in French-speaking Switzerland in the prevention and diagnosis of pulmonary and cardiovascular diseases.

Chest CT scanning, coupled with low-dose technologies and artificial intelligence, now offers a precise and safe approach in Switzerland. At the CID Lausanne, this technical expertise is combined with personalized, human care for each patient.

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FAQ

Is a chest CT scan painful?
No, it's a painless and quick test.
What is the radiation dose?
Less than 1 mSv for low-dose screening scanners.
Is a medical prescription required in Switzerland?
Yes, a chest CT scan is performed upon prescription from a family doctor or specialist.
Is it covered by Swiss health insurance?
Yes, according to recognized medical indications, it is covered by basic insurance (LaMal).
What are the risks associated with low-dose CT scanning?
Radiation exposure is extremely low (often less than 1 mSv) and without significant risk. The examination is non-invasive, painless and requires no specific preparation.
Who should have a low-dose chest CT scan?
Mainly patients who are smokers or ex-smokers aged 50 to 80, patients monitored for pulmonary nodules, those with high cardiovascular risk or acute chest symptoms (pain, dyspnea).
How long does it take to get results?
The results are generally transmitted to the prescribing physician within 24 to 48 hours following the examination at the CID Lausanne.
Is artificial intelligence replacing the radiologist?
No, AI assists the radiologist to increase accuracy, early detection and speed up analysis, but the final decision always remains validated by an FMH specialist in thoracic radiology.
Does the exam require an injection?
No for simple screening. A contrast injection is only considered in the case of more complex vascular investigations (pulmonary embolism, aortic pathologies, etc.).

How many diseases could we avoid if we were just looking at a little earlier?

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