CT Screening for Lung Cancer: Nonsolid Nodules in Baseline and Annual Repeat Rounds

Yankelevitz, David F.; Yip, Rowena; Smith, James P.; Liang, Mingzhu; Liu, Ying; Xu, Dong; Salvatore, Mary M.; Wolf, Andrea; Flores, Raja M.; Henschke, Claudia I.

doi:10.1148/radiol.2015142554

Cited by 198 publications

(146 citation statements)

References 24 publications

Supporting

Mentioning

141

Contrasting

Unclassified

Order By: Relevance

“…Yankelevitz et al 12 and Lee et al 14 also found that incidence scan SSNs were more frequently transient than baseline SSNs. We hypothesize that SSNs present at baseline often represent longstanding lesions, such as entities in the spectrum of lung adenocarcinoma, which are likely to persist.…”

Section: Discussionmentioning

confidence: 95%

“…Owing to intraobserver and interobserver variability in size measurement, growth was defined as a $3-mm increase in diameter 11 or development of solid component(s). 12 Statistical analysis was performed on R v. 3.1.2. 13 Differences between groups were analysed with the Mann-Whitney U-Wilcoxon test (for continuous variables) and x 2 test or Fisher's exact test (for categorical variables).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Screen-detected subsolid pulmonary nodules: long-term follow-up and application of the PanCan lung cancer risk prediction model

Zhao

Marshall

Yang

et al. 2016

BJR

View full text Add to dashboard Cite

Zhao and Marshall contributed equally.Objective: To report the long-term follow-up of subsolid nodules (SSNs) detected in participants of a prospective low-dose CT lung cancer screening cohort, and to investigate the utility of the PanCan model in stratifying risk in baseline SSNs. Methods: Participants underwent a baseline scan, two annual incidence scans and further follow-up scans for the detected nodules. All SSNs underwent a minimum of 2 years of follow-up (unless resolved or resected). Risk of malignancy was estimated using the PanCan model; discrimination [area under the receiver-operating characteristic curve (AUC)] and calibration (HosmerLemeshow goodness-of-fit test) were assessed. The Mann-Whitney U-Wilcoxon test was used to compare estimated risk between groups. Results: 70 SSNs were detected in 41 (16.0%) out of 256 total participants. Median follow-up period was 25.5 months (range 2.0-74.0 months). 29 (41.4%) SSNs were transient. Five (7.1%) SSNs were resected, all found to be Stage I lung adenocarcinoma, including one SSN stable in size for 3.0 years before growth was detected. The PanCan model had good discrimination for the 52 baseline SSNs (AUC 5 0.89; 95% confidence interval 0.76-1); the HosmerLemeshow goodness-of-fit test was non-significant (p 5 0.27). Estimated risk was significantly higher in the baseline SSNs found to be cancer vs those not found to be cancer after 2-6 years of follow-up (p , 0.01). Conclusion: Our findings support a long-term follow-up approach for screen-detected SSNs for 3 years or longer. The PanCan model appeared discriminatory and well calibrated in this cohort. Advances in knowledge:The PanCan model may have utility in identifying low-risk SSNs which could be followed with less frequent CT scans.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Methodsmentioning

confidence: 99%

Screen-detected subsolid pulmonary nodules: long-term follow-up and application of the PanCan lung cancer risk prediction model

Zhao

Marshall

Yang

et al. 2016

BJR

View full text Add to dashboard Cite

show abstract

“…Solid nodules may have external or internal cystic airspace or internal cavitation (15). Subsolid nodules may be either nonsolid or part-solid (7,19,20). A part-solid nodule is one that has internal components that completely obscure the lung parenchyma, and non-solid if none of the lung parenchyma is completely obscured.…”

Section: Definition Of Nodule Consistencymentioning

confidence: 99%

“…The workup of subsolid nodules should be based on the size of the largest solid component (19,20,(26)(27)(28). This recommendation is based on the radiologic findings as well as the pathology findings.…”

Section: Definition Of Nodule Consistencymentioning

confidence: 99%

“…Starting with the initial protocol developed for CT screening for lung cancer in 1992 (2-4), the protocol has been continuously updated based on the results of conferences held every 6 months (5,6) and on subsequent data emerging from CT screening (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). The protocol has been recently updated, integrating the latest technologies advances and knowledge (21).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The importance of the regimen of screening in maximizing the benefit and minimizing the harms

Henschke¹,

Li²,

Yip³

et al. 2016

Ann. Transl. Med.

Self Cite

View full text Add to dashboard Cite

Background: In CT screening for lung cancer, the regimen of screening is critical in diagnosing lung cancer early while limiting unnecessary tests and invasive procedures. The International Early Lung Cancer Action Program (I-ELCAP) has developed a regimen based on evidence collected in the I-ELCAP cohort of more than 70,000 participants.Methods: Important in the development of the regimen is the recognition of the profound difference between the first, baseline round of screening and all subsequent rounds of repeat screening. For each person undergoing screening, the baseline round happens only once while repeat rounds will be performed annually for many years.This difference needs to be clearly recognized as it is these annual rounds which allow for identification of small, early, yet aggressive, lung cancers which have high cure rates despite their aggressiveness. The importance of nodule consistency and size are key factors in the regimen. The regimen needs to be continuously updated by incorporating advances in technology and knowledge.Results: The use of the I-ELCAP regimen reduces the workup of participants in the screening program to less than 10% in the baseline round and less than 6% in the annual repeat rounds. By use of this regimen, estimated cure rate of lung cancers diagnosed under screening is 80% or higher in both baseline and annual repeat rounds. Conclusions:The I-ELCAP collaboration provides a new paradigm that answers the 2002 NCI call for multiple approaches to address relevant questions about screening and the Institute of Medicine (IOM) Roundtable on Evidence-based Medicine from the National Academy of Science's call for a "new clinical research paradigm that takes better advantage of data generated in the course of healthcare delivery would speed and improve the development of evidence for real-world decision making".

show abstract

Screening for Lung Cancer With Low-Dose Computed Tomography

Jonas

Reuland

Reddy

et al. 2021

JAMA

373

231

View full text Add to dashboard Cite

show abstract

CT Screening for Lung Cancer: Nonsolid Nodules in Baseline and Annual Repeat Rounds

Cited by 198 publications

References 24 publications

Screen-detected subsolid pulmonary nodules: long-term follow-up and application of the PanCan lung cancer risk prediction model

Screen-detected subsolid pulmonary nodules: long-term follow-up and application of the PanCan lung cancer risk prediction model

The importance of the regimen of screening in maximizing the benefit and minimizing the harms

Screening for Lung Cancer With Low-Dose Computed Tomography

Contact Info

Product

Resources

About