[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-368759-105":3,"doc-detail-368759-en":85,"detail-sidebar-cat-0-en-105":102},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":78,"head_meta":80,"extra_data":82,"updated_unix":84},105,"en","evaluation-of-imaging-techniques-for-early-detection-of-intrathoracic-cancers-in-symptomatic-patients-in-primary-care-a-systematic-review","Evaluation of imaging techniques for early detection of intrathoracic cancers in symptomatic patients in primary care - a systematic review","","Intrathoracic cancers—including lung cancer, mesothelioma, and thymoma—pose major diagnostic challenges in primary care with low prevalence. This systematic review synthesizes evidence on the diagnostic performance of imaging techniques in symptomatic patients, using QUADAS-2 and GRADE methods. Searches of MEDLINE, Embase, and Web of Science (Jan 2000–Jan 2024) included primary care studies reporting diagnostic accuracy. Thirty thousand-plus records yielded 13 included studies, showing heterogeneity across cancers, pathways, and reported metrics.",{"@graph":14,"@context":77},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/evaluation-of-imaging-techniques-for-early-detection-of-intrathoracic-cancers-in-symptomatic-patients-in-primary-care-a-systematic-review/368759/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/evaluation-of-imaging-techniques-for-early-detection-of-intrathoracic-cancers-in-symptomatic-patients-in-primary-care-a-systematic-review/368759.png","ImageObject",300,407,{"name":42,"@type":43},"Dipper","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-29","2026-09-23",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",7,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69,73],{"name":60,"@type":61,"acceptedAnswer":62},"What is the goal of the systematic review?","Question",{"text":63,"@type":64},"To summarize evidence on the diagnostic performance of imaging techniques that may support early detection of intrathoracic cancers in symptomatic primary care settings with low prevalence.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which imaging modalities were evaluated across the included studies?",{"text":68,"@type":64},"Studies investigated chest X-ray, CT, magnetic resonance imaging, positron emission tomography-CT, ultrasound, and scintigraphy, with sensitivity and specificity reported for several modalities.",{"name":70,"@type":61,"acceptedAnswer":71},"How were study quality and evidence strength assessed?",{"text":72,"@type":64},"The review used QUADAS-2 for risk of bias assessment and applied GRADE to evaluate the strength and quality of the evidence.",{"name":74,"@type":61,"acceptedAnswer":75},"What limitation did the review highlight regarding the existing evidence base?",{"text":76,"@type":64},"Few studies focused specifically on primary care symptomatic patients, with many using small samples and reporting limited accuracy data, indicating a need for more evaluations in general primary care populations.","https://schema.org",{"og:url":32,"og:type":79,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":81,"canonical":32},"index,follow",{"doc_id":83,"site_id":7},368759,1790699634,{"code":4,"msg":86,"data":87},"success",{"doc_id":83,"user_id":88,"nickname":42,"user_avatar":89,"doc_module":4,"category_id":55,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":90,"file_id":91,"file_url":92,"file_type":93,"file_size":94,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":95,"language":96,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":97,"faqs":98,"seo_title":99,"seo_description":12,"update_tm":100,"read_time":101},1374404997633,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Open access Original research  \n Evaluation of imaging techniques for  \nearly detection of intrathoracic cancersin symptomatic patients in primary care: a systematic review  \nBogdan Grigore  ,1 Jaime L Peters  ,1 Wasim Hamad,2 Natalia Calanzani  ,3,4 Lauren Asare,5 Fiona M Walter,6 Richard Neal5  \nTo cite: Grigore B, Peters JL, Hamad W, et al. Evaluation of imaging techniques for early detection of intrathoracic cancers in symptomatic patients in primary care: a systematic review. BMJ Open 2025;15:e091435 . doi:10 . 1136/ bmjopen-2024-091435  \n► Prepublication history and additional supplemental material for this paper are available online. To view these files, please visit the journal online ([https://doi.org/10.1136/](https://doi.org/10.1136/)[ ](https://doi.org/10.1136/)[bmjopen-2024-091435](bmjopen-2024-091435)) .  \nReceived 20 July 2024 Accepted 17 July 2025  \n© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY.  \nPublished by BMJ Group.  \n1Exeter Test Group, Department of Health and Community Sciences, University of Exeter, Exeter, UK  \n2Institute for Health and Primary Care, Queen Mary University of London, London, UK 3Academic Primary Care, University of Aberdeen Institute of Applied Health Sciences, Aberdeen, UK  \n4Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK 5University of Exeter, Exeter, UK 6Wolfson Institute of Population Health, Queen Mary University of London, London, UK  \nCorrespondence to  \nMr Bogdan Grigore; [b.grigore@exeter.ac.uk](b.grigore@exeter.ac.uk)  \nABSTRACT  \nObjectives Intrathoracic cancers, such as lung cancer, mesothelioma and thymoma, represent diagnostic challenges in primary care. We aimed to summarise evidence on the performance of imaging techniques that could aid the detection of intrathoracic cancers in low prevalence settings.  \nDesign Systematic review and quality appraisal using Quality Assessment of Diagnostic Accuracy Studies-2 and Grading of Recommendations Assessment, Development and Evaluation.  \nData sources MEDLINE, Embase and Web of Science were searched with a predesigned search strategy for articles from January 2000 to January 2024.  \nEligibility criteria We included studies relevant for primary care, where participants were suspected of having intrathoracic cancer and reported on at least one diagnostic performance measure. We excluded studies where the cancer diagnosis was already established.  \nData extraction and synthesis screening were conducted independently by two reviewers. Data extraction and quality appraisal were conducted by one reviewer and checked by a second reviewer.  \nResults Out of 30 539 records identified by the database searches, 13 studies were included. There was heterogeneity in the types of cancers, populations included and reported diagnosis pathways for suspected cancers. Imaging modalities investigated included chest X-ray (three studies), computer tomography (CT, six studies), magnetic resonance imaging (two studies), positron emission tomography CT (two studies), ultrasound (two studies) and scintigraphy (one study) . Chest Xray sensitivity reported for lung cancer ranged from 33.3% to 75 .9%, with specificity ranging from 83.2% to 95.5% . For CT, reported sensitivity varied from 58% for pleural malignancy to 100% for lung cancer. One study investigating an artificial intelligence tool to detect lung cancer found poor detection performance in a real-world patient cohort.  \nConclusions We found a limited number of studies reporting on the diagnostic performance of usual imaging techniques when used in unselected primary care settings for the diagnosis of intrathoracic cancer in symptomatic patients. There is a need for more studies evaluating such techniques in the general population presenting in primary care, where the prevalence is relatively low.  \nSTRENGTHS AND LIMITATIONS OF THIS STUDY   \n⇒ The systematic review used a comprehensive search of the literature for studies reporting on di","cbCaijYUSpYlKzFi","https://ap.wps.com/l/cbCaijYUSpYlKzFi","pdf",1119660,10,"English","# Abstract\n## Objectives and design\n## Data sources and eligibility\n## Results\n## Conclusions\n## Strengths and limitations\n# Background\n## Diagnostic challenges in primary care\n## Role of imaging in suspected malignancies","[{\"question\":\"What is the goal of the systematic review?\",\"answer\":\"To summarize evidence on the diagnostic performance of imaging techniques that may support early detection of intrathoracic cancers in symptomatic primary care settings with low prevalence.\"},{\"question\":\"Which imaging modalities were evaluated across the included studies?\",\"answer\":\"Studies investigated chest X-ray, CT, magnetic resonance imaging, positron emission tomography-CT, ultrasound, and scintigraphy, with sensitivity and specificity reported for several modalities.\"},{\"question\":\"How were study quality and evidence strength assessed?\",\"answer\":\"The review used QUADAS-2 for risk of bias assessment and applied GRADE to evaluate the strength and quality of the evidence.\"},{\"question\":\"What limitation did the review highlight regarding the existing evidence base?\",\"answer\":\"Few studies focused specifically on primary care symptomatic patients, with many using small samples and reporting limited accuracy data, indicating a need for more evaluations in general primary care populations.\"}]","Evaluation of imaging techniques for early detection of intrathoracic cancers in symptomatic patients in primary care - a systematic review | PDF",1790178370,25,{"code":4,"msg":86,"data":103},[104,108,112,116,121,126,129,134,139,142,145],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":105,"show_sort_weight":106,"slug":107},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":109,"show_sort_weight":110,"slug":111},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":113,"show_sort_weight":114,"slug":115},"Exam",70,"exam",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":118,"show_sort_weight":119,"slug":120},5,"Comic",60,"comic",{"id":122,"doc_module":4,"doc_module_name":25,"category_name":123,"show_sort_weight":124,"slug":125},6,"Technology",50,"technology",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":127,"slug":128},40,"healthcare",{"id":130,"doc_module":4,"doc_module_name":25,"category_name":131,"show_sort_weight":132,"slug":133},8,"Research & Report",30,"research-report",{"id":135,"doc_module":4,"doc_module_name":25,"category_name":136,"show_sort_weight":137,"slug":138},9,"Religion & Spirituality",20,"religion-spirituality",{"id":137,"doc_module":4,"doc_module_name":25,"category_name":140,"show_sort_weight":137,"slug":141},"World Cup","world-cup",{"id":95,"doc_module":4,"doc_module_name":25,"category_name":143,"show_sort_weight":95,"slug":144},"Lifestyle","lifestyle",{"id":146,"doc_module":4,"doc_module_name":25,"category_name":147,"show_sort_weight":117,"slug":148},19,"General","general"]