Pulmonary nodule detection: low-dose versus conventional CT.

Rusinek, Henry; Naidich, David P.; McGuinness, Georgeann; Leitman, Barry S.; McCauley, Dorothy I.; Krinsky, Glenn A.; Clayton, Karen; Cohen, Henry

doi:10.1148/radiology.209.1.9769838

Cited by 161 publications

(71 citation statements)

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“…The frequency and duration of follow-up is guided by consensus-based recommendations fi rst published by the Fleischner Society ( Fig 6 ) and subsequently endorsed in the second edition of these guidelines. 6,73 Decisions about the frequency and duration of follow-up for patients with small solid nodules need to weigh multiple considerations, including clinical risk factors; nodule size; the variable rate of nodule growth; the limited accuracy of available techniques for establishing growth by cross-sectional and volumetric measurements, especially for nodules that measure , 5 mm in size 81,83,130 ; concerns regarding radiation dose 24,131,132 ; risk factors for surgical complications; and cost. To date, recommendations from the Fleischner Society have not been subjected to formal validation, and limited data suggest that adherence may be suboptimal in some settings.…”

Section: 31mentioning

confidence: 99%

Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?

Gould

Donington

Lynch

et al. 2013

Chest

1,161

1,089

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we suggest that no additional diagnostic evaluation need be performed (Grade 2C) .Remark : This recommendation applies only to solid nodules. For guidance about follow-up of subsolid nodules, see Recommendations 6.5.1 to 6.5.4 . 2.3.3.In the individual with an indeterminate nodule that is identifi ed by chest radiography, we recommend that CT of the chest should be performed (preferably with thin sections Objectives: The objective of this article is to update previous evidence-based recommendations for evaluation and management of individuals with solid pulmonary nodules and to generate new recommendations for those with nonsolid nodules. Methods: We updated prior literature reviews, synthesized evidence, and formulated recommendations by using the methods described in the "Methodology for Development of Guidelines for Lung Cancer" in the American College of Chest Physicians Lung Cancer Guidelines, 3rd ed. Results: We formulated recommendations for evaluating solid pulmonary nodules that measure . 8 mm in diameter, solid nodules that measure Յ 8 mm in diameter, and subsolid nodules. The recommendations stress the value of assessing the probability of malignancy, the utility of imaging tests, the need to weigh the benefi ts and harms of different management strategies (nonsurgical biopsy, surgical resection, and surveillance with chest CT imaging), and the importance of eliciting patient preferences. Conclusions: Individuals with pulmonary nodules should be evaluated and managed by estimating the probability of malignancy, performing imaging tests to better characterize the lesions, evaluating the risks associated with various management alternatives, and eliciting their preferences for management. CHEST 2013; 143(5)(Suppl):e93S-e120SAbbreviations: AAH 5 atypical adenomatous hyperplasia; ACCP 5 American College of Chest Physicians; AIS 5 adenocarcinoma in situ; EBUS 5 endobronchial ultrasound; ENB 5 electromagnetic navigation bronchoscopy; FDG 5 fl uorodeoxyglucose; HU 5 Hounsfi eld unit; LR 5 likelihood ratio; SPECT 5 single-photon emission CT; TBB 5 transbronchial biopsy; TTNB 5 transthoracic needle biopsy; VATS 5 video-assisted thoracic surgery; VBN 5 virtual bronchoscopy navigation; VDT 5 volume doubling time

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Section: 31mentioning

confidence: 99%

Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?

Gould

Donington

Lynch

et al. 2013

Chest

1,161

1,089

View full text Add to dashboard Cite

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“…Establishing such protocols often involves the use of phantoms due to the difficulty of employing patients when comparing different technical or procedural factors involving ionizing radiation [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Optimization of Computed Tomography Protocols: Limitations of a Methodology Employing a Phantom with Location-Known Opacities

et al. 2013

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This study aimed to determine if phantom-based methodologies for optimization of hepatic lesion detection with computed tomography (CT) require randomization of lesion placement and inclusion of normal images. A phantom containing fixed opacities of varying size (diameters, 2.4, 4.8, and 9.5 mm) was scanned at various exposure and slice thickness settings. Two image sets were compared: All images in the first image set contained opacities with known location; the second image set contained images with opacities in random locations. Following Institutional Review Board approval, nine experienced observers scored opacity visualization using a 4-point confidence scale. Comparisons between image sets were performed using Spearman, Kappa, and Wilcoxon techniques. Observer scores demonstrated strong correlation between both approaches when all opacity sizes were combined (r=0.92, p<0.0001), for the 9.5 mm opacity (r=0.96, p<0.0001) and for the 2.4 mm opacity (r=0.64, p<0.05). There was no significant correlation for the 4.8 mm opacity. A significantly higher sensitivity score for the known compared with the unknown location was found for the 9.5 mm opacity and 4.8 mm opacity for a single slice thickness and exposure condition (p<0.05). Phantom-based optimization of CT hepatic examinations requires randomized lesion location when investigating challenging conditions; however, a standard phantom with fixed lesion location is suitable for the optimization of routine liver protocols. The development of more sophisticated phantoms or methods than those currently available is indicated for the optimization of CT protocols for diagnostic tasks involving the detection of subtle change.

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“…Their work concerns pulmonary nodule detection, CT colonography, renal colic, acute appendicitis, chronic sinusitis and screening (Rusinek et al 1998;van Gelder et al 2002;Tack et al 2003aTack et al , 2003bKeyzer et al 2004). A recent study by Horger et al (2005) showed that whole-body low-dose MDCT is appropriate for the diagnosis of lytic bone changes and for the assessment of fracture risk in multiple myeloma patients -among whom it represents a serious alternative to current standards.…”

Section: Modalities For Dose Reduction In Musculoskeletal Ctmentioning

confidence: 99%