Accuracy of Clinicians and Models for Estimating the Probability That a Pulmonary Nodule Is Malignant

Balekian, Alex; Silvestri, Gerard A.; Simkovich, Suzanne M.; Mestaz, Peter; Sanders, Gillian D; Daniel, Jamie; Porcel, Jackie; Gould, Michael K.

doi:10.1513/annalsats.201305-107oc

Cited by 37 publications

(18 citation statements)

References 16 publications

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“…[104][105][106][107] When externally validated, other models have modest accuracy. [107][108][109] Models based on lung nodules detected by chest radiography may not be applicable to the screening setting, [104][105][106] where more than half of lung cancers are 2 cm or less and about 25% of lung nodules are non-solid or partly solid and rarely visible on chest radiography. 80 92 When the full Pan Canadian model without spiculation (irregular margins) of the lung nodule was applied to an external validation dataset, the AUC was 0.97 (0.947 to 0.986).…”

Section: Tumor Volumementioning

confidence: 99%

Screening for lung cancer using low dose computed tomography

Tammemägi

Lam

2014

BMJ

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Screening for lung cancer with low dose computed tomography can reduce mortality from the disease by 20% in high risk smokers. This review covers the state of the art knowledge on several aspects of implementing a screening program. The most important are to identify people who are at high enough risk to warrant screening and the appropriate management of lung nodules found at screening. An accurate risk prediction model is more efficient than age and pack years of smoking alone at identifying those who will develop lung cancer and die from the disease. Algorithms are available for assessing people who screen positive to determine who needs additional imaging or invasive investigations. Concerns about low dose computed tomography screening include false positive results, overdiagnosis, radiation exposure, and costs. Further work is needed to define the frequency and duration of screening and to refine risk prediction models so that they can be used to assess the risk of lung cancer in special populations. Another important area is the use of computer vision software tools to facilitate high throughput interpretation of low dose computed tomography images so that costs can be reduced and the consistency of scan interpretation can be improved. Sufficient data are available to support the implementation of screening programs at the population level in stages that can be expanded when found to perform well to improve the outcome of patients with lung cancer.

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Section: Tumor Volumementioning

confidence: 99%

Screening for lung cancer using low dose computed tomography

Tammemägi

Lam

2014

BMJ

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“…Biomarkers can be classified in multiple ways based on anatomic site of sampling (e.g., serum, sputum, urine, and exhaled breath markers), target of detection (e.g., DNA methylation, gene expression, and ELISA), or type (e.g., DNA, microRNA, and autoantibody). In addition, several models using patient and nodule characteristics for predicting cancer risk in patients with solid nodules have been developed (37)(38)(39)(40)(41), but more studies are needed to determine whether these models provide incremental value above and beyond clinical judgment and intuition (42).…”

Section: Framing Research Questions For Novel Diagnostic Proceduresmentioning

confidence: 99%

An Official American Thoracic Society Research Statement: A Research Framework for Pulmonary Nodule Evaluation and Management

Slatore¹,

Horeweg²,

Jett³

et al. 2015

Am J Respir Crit Care Med

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“…Although several risk prediction models have been devised recently, they may not offer a significant improvement in distinguishing benign versus malignant nodule over clinical judgment alone. [17] Our results show that physicians in practice are able to effectively select very different approaches to lung nodules on the basis of FDG PET/CT results. FDG PET/CT suggested benign etiology in 51% of our study patient.…”

Section: Discussionmentioning

confidence: 73%

Utility of FDG PET/CT for Assessment of Lung Nodules Identified During Low Dose Computed Tomography Screening

Hadique

Jain

Hadi

et al. 2020

Preprint

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Background: Many clinical guidelines recommend FDG PET/CT for the evaluation of pulmonary nodules ≥ 8mm detected during low dose computed tomography (LDCT) lung cancer screening.However, its added value in this setting requires confirmation. We evaluated the clinical utility of FDG PET/CT, including incidental findings, during the evaluation of lung nodules detected on LDCT screening. Methods: A retrospective cohort study was performed among 75 patients who completed FDG PET/CT between January 2010 and December 2017, after lung nodules > 8mm had been detected on LDCT lung cancer screening. We report demographic variables, characteristics of the initial nodules on LDCT and FDG PET/CT, incidental findings on FDG PET/CT, as well as further work up performed and the influence of FDG PET/CT findings on management. Results: Nodules were reported to be benign on FDG PET/CT in 38/75 (50.6%) patients. Physicians chose either radiological follow-up or no further work up in all 38. FDG PET/CT was indeterminate or suggested malignancy in 37 (49.3%) patients. Biopsy was performed in 32 (86%) of these patients. Incidental findings on FDG PET/CT were reported in 37/75 (49%) patients. Further work-up of incidental findings was performed in 21/75 (28%) of patients. Conclusions : In this study, for majority of individuals with lung nodules identified during LDCT lung cancer screening, FDG PET/CT results were able to guide physicians in choosing between routine follow up or invasive biopsies. Conversely, 28% of these patients required additional investigations to address incidental findings.

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Accuracy of Clinicians and Models for Estimating the Probability That a Pulmonary Nodule Is Malignant

Cited by 37 publications

References 16 publications

Screening for lung cancer using low dose computed tomography

Screening for lung cancer using low dose computed tomography

An Official American Thoracic Society Research Statement: A Research Framework for Pulmonary Nodule Evaluation and Management

Utility of FDG PET/CT for Assessment of Lung Nodules Identified During Low Dose Computed Tomography Screening

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