Solitary Pulmonary Nodules: Meta-analytic Comparison of Cross-sectional Imaging Modalities for Diagnosis of Malignancy

Cronin, Paul; Dwamena, Ben A.; Kelly, Aine Marie; Carlos, Ruth C.

doi:10.1148/radiol.2463062148

Cited by 206 publications

(133 citation statements)

References 54 publications

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“…The 2008 meta-analysis 48 yielded an estimate for the sensitivity of PET scan that was somewhat higher (95%) than the estimate of 87% that we reported in the second edition of these guidelines. 6,39 Among more recent studies identifi ed by our updated literature review, estimates of sensitivity ranged from 72% to 94% ( Table S7 ).…”

Section: Pet Scanning With Fluorodeoxyglucosecontrasting

confidence: 60%

“…48 Pooled estimates of sensitivity ranged from 93% for dynamic CT scan to 94% for dynamic MRI to 95% for both PET and SPECT scans, whereas pooled specifi city ranged from 76% for dynamic CT scan to 79% for dynamic MRI to 82% for both PET and SPECT scans. Comparison of summary receiver operating characteristic curves showed that there were no signifi cant differences in accuracy among all four modalities.…”

Section: E101smentioning

confidence: 94%

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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: Pet Scanning With Fluorodeoxyglucosecontrasting

confidence: 60%

Section: E101smentioning

confidence: 94%

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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“…43 However, the majority of nodules are benign, even in smokers, raising concerns about over-investigation of potential malignancy. 44 Finally, although some screening studies have suggested improvements in lung cancer mortality in the screened population, other investigators have suggested that this may simply be due to detection of cancer earlier within its natural history or so-called 'lead-time' bias. 45 …”

Section: Chest X-ray and Computed Tomography Screeningmentioning

confidence: 99%

Advances in the prevention and treatment of lung cancer

Sethi²

2011

J R Coll Physicians Edinb

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Lung cancer remains the most common fatal malignancy in the Western world. Survival rates have only improved modestly over the past three decades and new approaches are urgently required. It is clear that a concerted effort to reduce cigarette smoking is required. However, about 10% of patients with lung cancer are never smokers, indicating genetic or other predisposition. Lung cancer screening programmes are being trialled to target high-risk populations. Genetic strategies will provide new methods for screening and predicting response to treatment. Current therapy for lung cancer has reached a plateau and novel agents have shown modest clinical efficacy. Understanding the mechanisms by which chronic inflammatory disorders such as chronic obstructive pulmonary disease contribute to lung cancer development will help to identify new biological targets and biomarkers of early disease. This review focuses on recent advances in lung cancer prevention and treatment.

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“…(9) One recent meta-analysis reported that dynamic CT and MRI, both of which are noninvasive methods, are equally accurate in distinguishing between malignant and benign solitary pulmonary nodules, the differences between the two tests being insignificant. (10) The authors of that meta-analysis found that, for the 10 dynamic CT studies, MRI had a pooled sensitivity of 93% (95% CI: 0.88-0.97) and a pooled specificity of 76% (95% CI: 0.68-0.97). (10) Koyama et al (11) reported that non-contrastenhanced MRI of the lung is as efficient as is thin-section multidetector CT in detecting malignant nodules.…”

Section: Introductionmentioning

confidence: 99%

“…(10) The authors of that meta-analysis found that, for the 10 dynamic CT studies, MRI had a pooled sensitivity of 93% (95% CI: 0.88-0.97) and a pooled specificity of 76% (95% CI: 0.68-0.97). (10) Koyama et al (11) reported that non-contrastenhanced MRI of the lung is as efficient as is thin-section multidetector CT in detecting malignant nodules. The authors also found that the overall nodule detection rate in each MRI sequence (82.5%) was significantly lower than was that of multidetector CT (97.0%), although there was no significant difference between the two techniques in terms of the detection rate for malignant nodules.…”

Section: Introductionmentioning

confidence: 99%

Ressonância magnética de pulmão: um novo passo no estudo das doenças pulmonares

et al. 2012

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Magnetic resonance imaging (MRI) of the lung has progressed tremendously in recent years. Because of improvements in speed and image quality, MRI is now ready for routine clinical use. The main advantage of MRI of the lung is its unique combination of structural and functional assessment in a single imaging session. We review the three major clinical indications for MRI of the lung: staging of lung tumors; evaluation of pulmonary vascular disease; and investigation of pulmonary abnormalities in patients who should not be exposed to radiation.Keywords: Magnetic resonance imaging; Lung; Lung diseases; Carcinoma, non-small-cell lung; Lung diseases, interstitial; Pneumonia. ResumoA ressonância magnética (RM) de pulmão progrediu tremendamente nos últimos anos. Devido a melhorias na velocidade e na qualidade de imagens, a RM de pulmão hoje está pronta para a utilização clínica de rotina. A principal vantagem da RM de pulmão é a sua combinação exclusiva de avaliação estrutural e funcional em uma única sessão de imagens. Revisamos aqui as três principais indicações clínicas da RM de pulmão: o estadiamento de tumores pulmonares, a avaliação de doença vascular pulmonar e a investigação de anormalidades pulmonares em pacientes que não podem ser expostos à radiação.Descritores: Imagem por ressonância magnética; Pulmão; Pneumopatias; Carcinoma pulmonar de células não pequenas; Doenças pulmonares intersticiais; Pneumonia.

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Solitary Pulmonary Nodules: Meta-analytic Comparison of Cross-sectional Imaging Modalities for Diagnosis of Malignancy

Abstract: Dynamic CT and MR, FDG PET, and (99m)Tc-depreotide SPECT are noninvasive and accurate in distinguishing malignant from benign SPNs; differences among these tests are nonsignificant.

Cited by 206 publications

References 54 publications

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

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

Advances in the prevention and treatment of lung cancer

Ressonância magnética de pulmão: um novo passo no estudo das doenças pulmonares

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