651
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Pure ground-glass opacity neoplastic lung nodules: histopathology, imaging, and management. AJR Am J Roentgenol 2014; 202:W224-33. [PMID: 24555618 DOI: 10.2214/ajr.13.11819] [Citation(s) in RCA: 139] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The purpose of this article is to discuss histologic diagnosis of pure pulmonary ground-glass opacity nodules (GGNs), high-resolution CT (HRCT) findings and pathologic correlation, and management. CONCLUSION When pure GGNs are greater than 15 mm in diameter with nodularity or have high pixel attenuation (>-472 HU), the nodules are more likely to be invasive adenocarcinomas. Sublobar resection with a secured safety margin and without nodal dissection is performed for HRCT-suggested pure-GGN invasive adenocarcinomas and has a 100% 5-year survival rate.
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652
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de Groot P, Munden RF. Radiology and Lung Cancer Screening. Lung Cancer 2014. [DOI: 10.1002/9781118468791.ch10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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653
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Travis WD. Pathology of Adenocarcinoma. Lung Cancer 2014. [DOI: 10.1002/9781118468791.ch8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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654
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Reply. AJR Am J Roentgenol 2014; 202:W412. [DOI: 10.2214/ajr.13.11997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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655
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Fussner LA, Midthun DE. Characteristics and management strategies for the incidental pulmonary nodule. Lung Cancer Manag 2014. [DOI: 10.2217/lmt.14.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY: Pulmonary nodules are frequent, unanticipated findings on imaging studies obtained for other purposes across all areas of medical practice. As nodule detection raises concern for malignancy, evaluation and follow-up of an incidental nodule is imperative. Clinicians are charged with counseling patients and directing further evaluation amid uncertainty and anxiety. The goals of follow-up and management are to identify malignant lesions at an early stage, while avoiding unnecessary procedures and potential harm to patients with benign nodules. In this review, we aim to outline the clinical and radiographic characteristics that can aid in likelihood stratification, to identify gaps in our current knowledge, and to present a logical approach to nodule management, based on the available evidence.
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Affiliation(s)
- Lynn A Fussner
- Division of Pulmonary & Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - David E Midthun
- Division of Pulmonary & Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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656
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Richards TB, White MC, Caraballo RS. Lung cancer screening with low-dose computed tomography for primary care providers. Prim Care 2014; 41:307-30. [PMID: 24830610 DOI: 10.1016/j.pop.2014.02.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This review provides an update on lung cancer screening with low-dose computed tomography (LDCT) and its implications for primary care providers. One of the unique features of lung cancer screening is the potential complexity in patient management if an LDCT scan reveals a small pulmonary nodule. Additional tests, consultation with multiple specialists, and follow-up evaluations may be needed to evaluate whether lung cancer is present. Primary care providers should know the resources available in their communities for lung cancer screening with LDCT and smoking cessation, and the key points to be addressed in informed and shared decision-making discussions with patients.
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Affiliation(s)
- Thomas B Richards
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Building 107, F-76, 4770 Buford Highway Northeast, Atlanta, GA 30341-3717, USA.
| | - Mary C White
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Building 107, F-76, 4770 Buford Highway Northeast, Atlanta, GA 30341-3717, USA
| | - Ralph S Caraballo
- Office of Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Building 107, F-79, 4770 Buford Highway Northeast, Atlanta, GA 30341-3717, USA
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657
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Maxwell AW, Klein JS, Dantey K, Mount SL, Butnor KJ, Leiman G. CT-Guided Transthoracic Needle Aspiration Biopsy of Subsolid Lung Lesions. J Vasc Interv Radiol 2014; 25:340-6, 346.e1. [DOI: 10.1016/j.jvir.2013.11.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 11/02/2013] [Accepted: 11/27/2013] [Indexed: 01/15/2023] Open
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658
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659
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Sim HJ, Choi SH, Chae EJ, Kim HR, Kim YH, Kim DK, Park SI. Surgical management of pulmonary adenocarcinoma presenting as a pure ground-glass nodule. Eur J Cardiothorac Surg 2014; 46:632-6; discussion 636. [PMID: 24566849 DOI: 10.1093/ejcts/ezu007] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES With recent advances in radiology, the detection of ground-glass nodules (GGNs) has become increasingly common. However, there still is no consensus on management, especially on the need for systemic lymph node (LN) dissection. The purpose of this study was to evaluate the surgical outcomes on the basis of the extent of resection of the primary lesion and mediastinal LN dissection and to carefully suggest appropriate treatment strategies in the patients with pulmonary adenocarcinoma presenting as pure ground-glass opacities. METHODS From January 2006 to December 2010, 1267 patients with pulmonary adenocarcinoma, including adenocarcinoma in situ, underwent curative-intent surgical resection. Among these patients, pure GGNs were confirmed in 48 patients on preoperative chest computed tomography (CT) by an experienced radiologist, and 42 underwent systemic LN dissection or sampling. We retrospectively reviewed the perioperative data and postoperative outcomes. RESULTS The median age of the patients was 56 (range, 35-78) years, and 26 (54.2%) patients were male. The median size of the nodules was 12 (5-30) mm, and 8 (16.7%) had multiple lesions at the time of operation. The median duration between the initial diagnosis and operation was 4 (0-45) months. Preoperative positron emission tomography/CT was taken in 36 (75.0%) patients, which showed no significant metabolic uptake. For curative resection, lobectomy was performed in 32 (66.7%) patients, segmentectomy in 4, and wedge resection in 12. Clear resection margins were reported in all patients. Forty-two patients underwent systemic mediastinal LN dissection or sampling, and the median number of dissected LNs was 23 (7-53). No LN was reported as positive for malignancy. The median follow-up duration after the first operation was 39 (23-77) months, and there were no cases of late mortality, local recurrence or nodal recurrence. Recurrent GGNs have been developed in 6 (12.5%) patients. CONCLUSIONS For pure GGNs, limited resection can be performed when complete resection is obtained, as it was sufficient for cure and especially because there is high probability of multiple lesions. We were unable to demonstrate any additional therapeutic benefit with mediastinal LN dissection in patients with pure GGNs.
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Affiliation(s)
- Hee Je Sim
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Seoul, Republic of Korea
| | - Se Hoon Choi
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Seoul, Republic of Korea
| | - Eun Jin Chae
- Department of Radiology, Asan Medical Center, Seoul, Republic of Korea
| | - Hyeong Ryul Kim
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Seoul, Republic of Korea
| | - Yong-Hee Kim
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Seoul, Republic of Korea
| | - Dong Kwan Kim
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Seoul, Republic of Korea
| | - Seung-Il Park
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Seoul, Republic of Korea
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660
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Vansteenkiste J, Crinò L, Dooms C, Douillard JY, Faivre-Finn C, Lim E, Rocco G, Senan S, Van Schil P, Veronesi G, Stahel R, Peters S, Felip E. 2nd ESMO Consensus Conference on Lung Cancer: early-stage non-small-cell lung cancer consensus on diagnosis, treatment and follow-up. Ann Oncol 2014; 25:1462-74. [PMID: 24562446 DOI: 10.1093/annonc/mdu089] [Citation(s) in RCA: 342] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
To complement the existing treatment guidelines for all tumour types, ESMO organises consensus conferences to focus on specific issues in each type of tumour. The 2nd ESMO Consensus Conference on Lung Cancer was held on 11-12 May 2013 in Lugano. A total of 35 experts met to address several questions on non-small-cell lung cancer (NSCLC) in each of four areas: pathology and molecular biomarkers, first-line/second and further lines in advanced disease, early-stage disease and locally advanced disease. For each question, recommendations were made including reference to the grade of recommendation and level of evidence. This consensus paper focuses on early-stage disease.
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Affiliation(s)
- J Vansteenkiste
- Respiratory Oncology Unit (Pulmonology), University Hospital KU Leuven, Leuven, Belgium
| | - L Crinò
- Department of Oncology, Santa Maria Della Misericordia Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - C Dooms
- Respiratory Oncology Unit (Pulmonology), University Hospital KU Leuven, Leuven, Belgium
| | - J Y Douillard
- Department of Medical Oncology, Integrated Centers of Oncology R. Gauducheau, St Herblain, France
| | - C Faivre-Finn
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester
| | - E Lim
- Imperial College and the Academic Division of Thoracic Surgery, Royal Brompton Hospital, London, UK
| | - G Rocco
- Department of Thoracic Surgery and Oncology, National Cancer Institute, Pascale Foundation, IRCCS, Naples, Italy
| | - S Senan
- Department of Radiation Oncology, VU University Medical Centre, Amsterdam, The Netherlands
| | - P Van Schil
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem (Antwerp), Belgium
| | - G Veronesi
- Department of Thoracic Surgery, European Institute of Oncology, Milan, Italy
| | - R Stahel
- Clinic of Oncology, University Hospital, Zürich
| | - S Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - E Felip
- Department of Medical Oncology, Vall D'Hebron University Hospital, Barcelona, Spain
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661
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Miettinen OS, Henschke CI, Smith JP, Yankelevitz DF. Is ground glass descriptive of a type of pulmonary nodule? Radiology 2014; 270:311-2. [PMID: 24354385 DOI: 10.1148/radiol.13131665] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Olli S Miettinen
- Department of Epidemiology, Biostatistics, and Occupational Health and Department of Medicine, McGill University, Montreal, Quebec, Canada *
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662
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Detection of time-varying structures by large deformation diffeomorphic metric mapping to aid reading of high-resolution CT images of the lung. PLoS One 2014; 9:e85580. [PMID: 24454894 PMCID: PMC3890326 DOI: 10.1371/journal.pone.0085580] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 11/28/2013] [Indexed: 12/21/2022] Open
Abstract
Objectives To evaluate the accuracy of advanced non-linear registration of serial lung Computed Tomography (CT) images using Large Deformation Diffeomorphic Metric Mapping (LDDMM). Methods Fifteen cases of lung cancer with serial lung CT images (interval: 62.2±26.9 days) were used. After affine transformation, three dimensional, non-linear volume registration was conducted using LDDMM with or without cascading elasticity control. Registration accuracy was evaluated by measuring the displacement of landmarks placed on vessel bifurcations for each lung segment. Subtraction images and Jacobian color maps, calculated from the transformation matrix derived from image warping, were generated, which were used to evaluate time-course changes of the tumors. Results The average displacement of landmarks was 0.02±0.16 mm and 0.12±0.60 mm for proximal and distal landmarks after LDDMM transformation with cascading elasticity control, which was significantly smaller than 3.11±2.47 mm and 3.99±3.05 mm, respectively, after affine transformation. Emerged or vanished nodules were visualized on subtraction images, and enlarging or shrinking nodules were displayed on Jacobian maps enabled by highly accurate registration of the nodules using LDDMM. However, some residual misalignments were observed, even with non-linear transformation when substantial changes existed between the image pairs. Conclusions LDDMM provides accurate registration of serial lung CT images, and temporal subtraction images with Jacobian maps help radiologists to find changes in pulmonary nodules.
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663
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Lee SH, Lee SM, Goo JM, Kim KG, Kim YJ, Park CM. Usefulness of texture analysis in differentiating transient from persistent part-solid nodules(PSNs): a retrospective study. PLoS One 2014; 9:e85167. [PMID: 24416357 PMCID: PMC3885675 DOI: 10.1371/journal.pone.0085167] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 11/24/2013] [Indexed: 01/12/2023] Open
Abstract
Background Early discrimination between transient and persistent par-solid ground-glass nodules (PSNs) at CT is essential for patient management. The objective of our study was to retrospectively investigate the value of texture analysis in differentiating pulmonary transient and persistent PSNs in addition to clinical and CT features. Methods This retrospective study was performed with IRB approval and a waiver of the requirement for patients' informed consent. From January 2007 to October 2009, we identified 77 individuals (39 men and 38 women; mean age, 55 years) with 86 PSNs on thin-section chest CT. Thirty-nine PSNs in 31 individuals were transient and 47 PSNs in 46 patients were persistent. The clinical, CT, and texture features of PSNs were evaluated. To investigate the additional value of texture analysis in differentiating transient from persistent PSNs, logistic regression analysis and C-statistics were performed. Results Between transient and persistent PSNs, there were significant differences in age, gender, smoking history, and eosinophil count among the clinical features. As for thin-section CT features, there were significant differences in lesion size, solid portion size, and lesion multiplicity. In terms of texture features, there were significant differences in mean attenuation, skewness of whole PSN, attenuation ratio of whole PSN to inner solid portion, and 5-, 10-, 25-, 50-percentile CT numbers of whole PSN. Multivariate analysis revealed eosinophilia, lesion size, lesion multiplicity, mean attenuation of whole PSN, skewness of whole PSN, and 5-percentile CT number were significant independent predictors of transient PSNs. (P<0.05) C-statistics revealed that texture analysis incorporating clinical and CT features (AUC, 92.9%) showed significantly higher differentiating performance of transient from persistent PSNs compared with the clinical and CT features alone (AUC, 79.0%). (P = 0.004) Conclusion Texture analysis of PSNs in addition to clinical and CT features analysis has the potential to improve the differentiation of transient from persistent PSNs.
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Affiliation(s)
- Sang Hwan Lee
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Sang Min Lee
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
| | - Jin Mo Goo
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Kwang-Gi Kim
- Department of Biomedical Engineering, Division of Basic & Applied Sciences, National Cancer Center, Gyeonggi-Do, Korea
| | - Young Jae Kim
- Department of Biomedical Engineering, Division of Basic & Applied Sciences, National Cancer Center, Gyeonggi-Do, Korea
| | - Chang Min Park
- Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
- * E-mail:
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664
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Detterbeck FC. Clearing up opacities. Chest 2014; 145:9-10. [PMID: 24394813 DOI: 10.1378/chest.13-1765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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665
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Lim HJ, Ahn S, Lee KS, Han J, Shim YM, Woo S, Kim JH, Yie M, Lee HY, Yi CA. Persistent pure ground-glass opacity lung nodules ≥ 10 mm in diameter at CT scan: histopathologic comparisons and prognostic implications. Chest 2014; 144:1291-1299. [PMID: 23722583 DOI: 10.1378/chest.12-2987] [Citation(s) in RCA: 188] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Little is known about the histopathology and prognosis of persistent pure ground-glass opacity nodules (GGNs) of ≥ 10 mm in diameter. We aimed to compare the morphologic features of persistent pure GGNs of ≥ 10 mm in diameter at thin-section CT (TSCT) scan with histopathology and patient prognosis. METHODS A total of 46 resected GGNs that were evaluated with TSCT scan and followed up for ≥ 3 years were included in this study. Correlations between histopathology (adenocarcinoma in situ [AIS], minimally invasive adenocarcinoma [MIA], and invasive adenocarcinoma) and CT scan characteristics were examined. CT scan and clinicodemographic data were investigated by univariate and multivariate analyses to identify features that helped distinguish invasive adenocarcinoma from AIS or MIA. Disease recurrence was also evaluated. RESULTS The nodules included 19 AISs (41%), nine MIAs (20%), and 18 invasive adenocarcinomas (39%). On univariate analysis, the presence of air bronchogram (P = .012), size of nodule (P = .032, cutoff = 16.4 mm in diameter), and mass of nodule (P = .040, cutoff = 0.472 g) were significant factors that differentiated invasive adenocarcinoma from AIS or MIA. On multivariate analysis, size (P = .010) and mass of nodule (P = .016) were significant determinants for invasive adenocarcinoma. There were no cases of recurrence during a follow-up period of ≥ 3 years after surgical resection. CONCLUSIONS In persistent pure GGNs of ≥ 10 mm in diameter, the size and mass of the nodule are determinants of invasive adenocarcinoma, for which surgical resection leads to excellent prognosis.
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Affiliation(s)
- Hyun-Ju Lim
- Department of Radiology and Center for Imaging Science, Seoul, South Korea
| | - Soomin Ahn
- Department of Pathology, Seoul, South Korea
| | - Kyung Soo Lee
- Department of Radiology and Center for Imaging Science, Seoul, South Korea.
| | | | | | - Sookyoung Woo
- Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae-Hun Kim
- Department of Radiology and Center for Imaging Science, Seoul, South Korea
| | - Miyeon Yie
- Department of Radiology and Center for Imaging Science, Seoul, South Korea
| | - Ho Yun Lee
- Department of Radiology and Center for Imaging Science, Seoul, South Korea
| | - Chin A Yi
- Department of Radiology and Center for Imaging Science, Seoul, South Korea
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666
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Frauenfelder T, Puhan M, Lazor R, von Garnier C, Bremerich J, Niemann T, Christe A, Montet X, Gautschi O, Weder W, Kohler M. Early Detection of Lung Cancer: A Statement from an Expert Panel of the Swiss University Hospitals on Lung Cancer Screening. Respiration 2014; 87:254-64. [DOI: 10.1159/000357049] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 10/19/2013] [Indexed: 11/19/2022] Open
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667
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Girard N, Gounant V, Mennecier B, Greillier L, Cortot A, Couraud S, Besse B, Brouchet L, Castelnau O, Ferretti G, Frappé P, Khalil A, Lefebure P, Laurent F, Liebart S, Margery J, Molinier O, Quoix E, Revel MP, Stach B, Souquet PJ, Thomas P, Trédaniel J, Lemarié E, Zalcman G, Barlési F, Milleron B. Le dépistage individuel du cancer broncho-pulmonaire en pratique. Perspectives sur les propositions du groupe de travail pluridisciplinaire de l’Intergroupe francophone de cancérologie thoracique, de la Société d’imagerie thoracique et du Groupe d’oncologie de langue française. Rev Mal Respir 2014; 31:91-103. [DOI: 10.1016/j.rmr.2013.10.641] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 09/18/2013] [Indexed: 12/21/2022]
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668
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Ko JP, Naidich DP. Current Readings: Radiologic Interpretation of the Part-Solid Nodule: Clinical Relevance and Novel Technologies. Semin Thorac Cardiovasc Surg 2014; 26:145-56. [DOI: 10.1053/j.semtcvs.2014.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2014] [Indexed: 12/21/2022]
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669
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Christe A, Szucs-Farkas Z, Huber A, Steiger P, Leidolt L, Roos JE, Heverhagen J, Ebner L. Optimal dose levels in screening chest CT for unimpaired detection and volumetry of lung nodules, with and without computer assisted detection at minimal patient radiation. PLoS One 2013; 8:e82919. [PMID: 24386126 PMCID: PMC3873253 DOI: 10.1371/journal.pone.0082919] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 10/29/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The aim of this phantom study was to minimize the radiation dose by finding the best combination of low tube current and low voltage that would result in accurate volume measurements when compared to standard CT imaging without significantly decreasing the sensitivity of detecting lung nodules both with and without the assistance of CAD. METHODS An anthropomorphic chest phantom containing artificial solid and ground glass nodules (GGNs, 5-12 mm) was examined with a 64-row multi-detector CT scanner with three tube currents of 100, 50 and 25 mAs in combination with three tube voltages of 120, 100 and 80 kVp. This resulted in eight different protocols that were then compared to standard CT sensitivity (100 mAs/120 kVp). For each protocol, at least 127 different nodules were scanned in 21-25 phantoms. The nodules were analyzed in two separate sessions by three independent, blinded radiologists and computer-aided detection (CAD) software. RESULTS The mean sensitivity of the radiologists for identifying solid lung nodules on a standard CT was 89.7% ± 4.9%. The sensitivity was not significantly impaired when the tube and current voltage were lowered at the same time, except at the lowest exposure level of 25 mAs/80 kVp [80.6% ± 4.3% (p = 0.031)]. Compared to the standard CT, the sensitivity for detecting GGNs was significantly lower at all dose levels when the voltage was 80 kVp; this result was independent of the tube current. The CAD significantly increased the radiologists' sensitivity for detecting solid nodules at all dose levels (5-11%). No significant volume measurement errors (VMEs) were documented for the radiologists or the CAD software at any dose level. CONCLUSIONS Our results suggest a CT protocol with 25 mAs and 100 kVp is optimal for detecting solid and ground glass nodules in lung cancer screening. The use of CAD software is highly recommended at all dose levels.
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Affiliation(s)
- Andreas Christe
- Department of Radiology, Hospital and University of Bern, Inselspital, Bern, Switzerland
- * E-mail:
| | | | - Adrian Huber
- Department of Radiology, Hospital and University of Bern, Inselspital, Bern, Switzerland
| | - Philipp Steiger
- Department of Radiology, Hospital and University of Bern, Inselspital, Bern, Switzerland
| | - Lars Leidolt
- Department of Radiology, Hospital and University of Bern, Inselspital, Bern, Switzerland
| | - Justus E. Roos
- Department of Radiology, Duke University, Durham, North Carolina, United States of America
| | - Johannes Heverhagen
- Department of Radiology, Hospital and University of Bern, Inselspital, Bern, Switzerland
| | - Lukas Ebner
- Department of Radiology, Hospital and University of Bern, Inselspital, Bern, Switzerland
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670
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Jacobs C, van Rikxoort EM, Twellmann T, Scholten ET, de Jong PA, Kuhnigk JM, Oudkerk M, de Koning HJ, Prokop M, Schaefer-Prokop C, van Ginneken B. Automatic detection of subsolid pulmonary nodules in thoracic computed tomography images. Med Image Anal 2013; 18:374-84. [PMID: 24434166 DOI: 10.1016/j.media.2013.12.001] [Citation(s) in RCA: 119] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 11/22/2013] [Accepted: 12/02/2013] [Indexed: 12/24/2022]
Abstract
Subsolid pulmonary nodules occur less often than solid pulmonary nodules, but show a much higher malignancy rate. Therefore, accurate detection of this type of pulmonary nodules is crucial. In this work, a computer-aided detection (CAD) system for subsolid nodules in computed tomography images is presented and evaluated on a large data set from a multi-center lung cancer screening trial. The paper describes the different components of the CAD system and presents experiments to optimize the performance of the proposed CAD system. A rich set of 128 features is defined for subsolid nodule candidates. In addition to previously used intensity, shape and texture features, a novel set of context features is introduced. Experiments show that these features significantly improve the classification performance. Optimization and training of the CAD system is performed on a large training set from one site of a lung cancer screening trial. Performance analysis on an independent test from another site of the trial shows that the proposed system reaches a sensitivity of 80% at an average of only 1.0 false positive detections per scan. A retrospective analysis of the output of the CAD system by an experienced thoracic radiologist shows that the CAD system is able to find subsolid nodules which were not contained in the screening database.
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Affiliation(s)
- Colin Jacobs
- Diagnostic Image Analysis Group, Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands; Fraunhofer MEVIS, Bremen, Germany.
| | - Eva M van Rikxoort
- Diagnostic Image Analysis Group, Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands; Fraunhofer MEVIS, Bremen, Germany
| | | | - Ernst Th Scholten
- Department of Radiology, Utrecht University Medical Center, Utrecht, The Netherlands; Department of Radiology, Haarlemmer Kennemer Gasthuis, Haarlem, The Netherlands
| | - Pim A de Jong
- Department of Radiology, Utrecht University Medical Center, Utrecht, The Netherlands
| | | | - Matthijs Oudkerk
- Department of Radiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Harry J de Koning
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Mathias Prokop
- Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Cornelia Schaefer-Prokop
- Meander Medical Centre, Amersfoort, The Netherlands; Diagnostic Image Analysis Group, Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bram van Ginneken
- Diagnostic Image Analysis Group, Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands; Fraunhofer MEVIS, Bremen, Germany
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671
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Ahmed R, Qureshi NR, Rintoul RC. Investigation and management of the solitary pulmonary nodule. Clin Med (Lond) 2013; 13 Suppl 6:s36-40. [PMID: 24298181 DOI: 10.7861/clinmedicine.13-6-s36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
With the advent of multi-detector computed tomography, the identification of solitary pulmonary nodules is becoming ever more common. Although the prevalence of malignancy in a high risk population is only 1-1.5%, accurate identification of malignant nodules is essential to allow optimal treatment. In this article we review the most common causes of solitary pulmonary nodules and discuss diagnostic algorithms as well as some of the novel diagnostic imaging techniques in development.
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672
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Christe A, Leidolt L, Huber A, Steiger P, Szucs-Farkas Z, Roos J, Heverhagen J, Ebner L. Lung cancer screening with CT: Evaluation of radiologists and different computer assisted detection software (CAD) as first and second readers for lung nodule detection at different dose levels. Eur J Radiol 2013; 82:e873-8. [DOI: 10.1016/j.ejrad.2013.08.026] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 07/12/2013] [Accepted: 08/05/2013] [Indexed: 11/15/2022]
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673
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Arenberg D. Implementation of a Lung Cancer-Screening Program. CURRENT SURGERY REPORTS 2013. [DOI: 10.1007/s40137-013-0027-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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674
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675
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Scholten ET, de Hoop B, Jacobs C, van Amelsvoort-van de Vorst S, van Klaveren RJ, Oudkerk M, Vliegenthart R, de Koning HJ, van der Aalst CM, Mali WTM, Gietema HA, Prokop M, van Ginneken B, de Jong PA. Semi-automatic quantification of subsolid pulmonary nodules: comparison with manual measurements. PLoS One 2013; 8:e80249. [PMID: 24278264 PMCID: PMC3837004 DOI: 10.1371/journal.pone.0080249] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 10/11/2013] [Indexed: 12/27/2022] Open
Abstract
Rationale Accurate measurement of subsolid pulmonary nodules (SSN) is becoming increasingly important in the management of these nodules. SSNs were previously quantified with time-consuming manual measurements. The aim of the present study is to test the feasibility of semi-automatic SSNs measurements and to compare the results to the manual measurements. Methods In 33 lung cancer screening participants with 33 SSNs, the nodules were previously quantified by two observers manually. In the present study two observers quantified these nodules by using semi-automated nodule volumetry software. Nodules were quantified for effective diameter, volume and mass. The manual and semi-automatic measurements were compared using Bland-Altman plots and paired T tests. Observer agreement was calculated as an intraclass correlation coefficient. Data are presented as mean (SD). Results Semi-automated measurements were feasible in all 33 nodules. Nodule diameter, volume and mass were 11.2 (3.3) mm, 935 (691) ml and 379 (311) milligrams for observer 1 and 11.1 (3.7) mm, 986 (797) ml and 399 (344) milligrams for observer 2, respectively. Agreement between observers and within observer 1 for the semi-automatic measurements was good with an intraclass correlation coefficient >0.89. For observer 1 and observer 2, measured diameter was 8.8% and 10.3% larger (p<0.001), measured volume was 24.3% and 26.5% larger (p<0.001) and measured mass was 10.6% and 12.0% larger (p<0.001) with the semi-automatic program compared to the manual measurements. Conclusion Semi-automated measurement of the diameter, volume and mass of SSNs is feasible with good observer agreement. Semi-automated measurement makes quantification of mass and volume feasible in daily practice.
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Affiliation(s)
- Ernst Th. Scholten
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Radiology, Kennemer Gasthuis, Haarlem, The Netherlands
| | - Bartjan de Hoop
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Colin Jacobs
- Image Analysis Group, Department of Radiology UMC St Radboud, Nijmegen, The Netherlands
- Fraunhofer MEVIS, Bremen, Germany
| | | | - Rob J. van Klaveren
- Departement of Pulmonology, Lievensberg Hospital, Bergen op Zoom, The Netherlands
| | - Matthijs Oudkerk
- Department of Radiology, University Medical Centre, Groningen, The Netherlands
| | | | - Harry J. de Koning
- Department of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands
| | | | - Willem Th M. Mali
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Hester A. Gietema
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Mathias Prokop
- Department of Radiology, UMC St Radboud, Nijmegen, The Netherlands
| | - Bram van Ginneken
- Image Analysis Group, Department of Radiology UMC St Radboud, Nijmegen, The Netherlands
- Fraunhofer MEVIS, Bremen, Germany
| | - Pim A. de Jong
- Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands
- * E-mail:
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676
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Management of lung nodules in 2013. Diagn Interv Imaging 2013; 94:1063-4. [PMID: 24216077 DOI: 10.1016/j.diii.2013.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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677
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Furman AM, Dit Yafawi JZ, Soubani AO. An update on the evaluation and management of small pulmonary nodules. Future Oncol 2013; 9:855-65. [PMID: 23718306 DOI: 10.2217/fon.13.17] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The widespread utilization of chest CT scans has increased the importance of the proper evaluation of incidentally found lung nodules. The primary goal in the evaluation of these nodules is to determine whether they are malignant or benign. Clinical factors such as older age, tobacco smoking, and current or remote history of malignancy increase the pretest likelihood of malignancy. Radiological features of these nodules are important in differentiating benign from malignant lesions. However, the etiology of the lung nodules frequently remains indeterminate and requires further evaluation. The approach to the management of indeterminate lung nodules ranges between observation with repeat chest CT scan, further diagnostic studies such as PET scan or invasive procedures to obtain tissue diagnosis. This article reviews the importance of the different radiological features of lung nodules. This is followed by an update on the approach to the management of the different types of small lung nodules.
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Affiliation(s)
- Alexandre M Furman
- Division of Pulmonary, Critical Care & Sleep Medicine, Wayne State University School of Medicine, Harper University Hospital, 3990 John R- 3 Hudson, Detroit, MI 48201, USA
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678
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Effect of radiation dose and iterative reconstruction on lung lesion conspicuity at MDCT: Does one size fit all? Eur J Radiol 2013; 82:e726-33. [DOI: 10.1016/j.ejrad.2013.07.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 06/29/2013] [Accepted: 07/01/2013] [Indexed: 12/28/2022]
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679
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Kim H, Park CM, Woo S, Lee SM, Lee HJ, Yoo CG, Goo JM. Pure and Part-Solid Pulmonary Ground-Glass Nodules: Measurement Variability of Volume and Mass in Nodules with a Solid Portion Less than or Equal to 5 mm. Radiology 2013; 269:585-593. [DOI: 10.1148/radiol.13121849] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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680
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Lederlin M, Revel MP, Khalil A, Ferretti G, Milleron B, Laurent F. Management strategy of pulmonary nodule in 2013. Diagn Interv Imaging 2013; 94:1081-94. [PMID: 24034970 DOI: 10.1016/j.diii.2013.05.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- M Lederlin
- Service d'imagerie médicale, Université Bordeaux Segalen, CHU Bordeaux Groupe Sud, avenue de Magellan, 33600 Pessac, France.
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681
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Kakinuma R, Ashizawa K, Kusunoki Y, Kobayashi T, Kondo T, Nakagawa T, Hatakeyama M, Maruyama Y. Management of Subsolid Nodules. Chest 2013; 144:1741-1742. [DOI: 10.1378/chest.13-1314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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682
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Gould MK, Wiener RS. Management of Subsolid Nodules: Response. Chest 2013; 144:1742. [DOI: 10.1378/chest.13-2027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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683
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Abstract
In this review, we focus on the radiologic, clinical, and pathologic aspects primarily of solitary subsolid pulmonary nodules. Particular emphasis will be placed on the pathologic classification and correlative computed tomography (CT) features of adenocarcinoma of the lung. The capabilities of fluorodeoxyglucose positron emission tomography-CT and histologic sampling techniques, including CT-guided biopsy, endoscopic-guided biopsy, and surgical resection, are discussed. Finally, recently proposed management guidelines by the Fleischner Society and the American College of Chest Physicians are reviewed.
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Affiliation(s)
- Roy A Raad
- Department of Radiology, NYU Langone Medical Center, 660 First Avenue, New York, NY 10016, USA.
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684
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Hunnibell LS, Slatore CG, Ballard EA. Foundations for Lung Nodule Management for Nurse Navigators. Clin J Oncol Nurs 2013; 17:525-31. [DOI: 10.1188/13.cjon.525-531] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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685
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Seidelman JL, Myers JL, Quint LE. Incidental, subsolid pulmonary nodules at CT: etiology and management. Cancer Imaging 2013; 13:365-73. [PMID: 24061063 PMCID: PMC3800431 DOI: 10.1102/1470-7330.2013.9025] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Pulmonary nodules, both solid and subsolid, are common incidental findings on computed tomography (CT) studies. Subsolid nodules (SSNs) may be further classified as either pure ground-glass nodules or part-solid nodules. The differential diagnosis for an SSN is broad, including infection, organizing pneumonia, inflammation, hemorrhage, focal fibrosis, and neoplasm. Adenocarcinomas of the lung are currently the most common type of lung cancer, representing 30–35% of all primary lung tumors, and the subtype of bronchioloalveolar cell carcinoma (BAC) commonly presents as an SSN. In 2011, a new classification system for lung adenocarcinomas was proposed by the International Association for the Study of Lung Cancer, the American Thoracic Society, and the European Respiratory Society. An important feature of the new system is the relinquishment of the term BAC in favor of more specific histologic subtypes. It has been reported that these subtypes are associated with characteristic CT findings. This article reviews the new classification system of lung adenocarcinomas, discusses and illustrates the associated CT findings, and outlines the current recommendations for further diagnosis, treatment, and follow-up of SSNs based on computed tomography findings.
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686
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Xie X, Heuvelmans MA, van Ooijen PMA, Oudkerk M, Vliegenthart R. A practical approach to radiological evaluation of CT lung cancer screening examinations. Cancer Imaging 2013; 13:391-9. [PMID: 24061210 PMCID: PMC3781644 DOI: 10.1102/1470-7330.2013.9043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Lung cancer is the most common cause of cancer-related death in the world. The Dutch-Belgian Randomized Lung Cancer Screening Trial (Dutch acronym: NELSON) was launched to investigate whether screening for lung cancer by low-dose multidetector computed tomography (CT) in high-risk patients will lead to a decrease in lung cancer mortality. The NELSON lung nodule management is based on nodule volumetry and volume doubling time assessment. Evaluation of CT examinations in lung cancer screening can also include assessment of coronary calcification, emphysema and airway wall thickness, biomarkers for major diseases that share risk factors with lung cancer. In this review, a practical approach to the radiological evaluation of CT lung cancer screening examinations is described.
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Affiliation(s)
- Xueqian Xie
- Center for Medical Imaging - North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Radiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands
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687
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Fungal Infection Mimicking Pulmonary Malignancy: Clinical and Radiological Characteristics. Lung 2013; 191:655-62. [DOI: 10.1007/s00408-013-9506-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 08/19/2013] [Indexed: 01/09/2023]
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688
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McWilliams A, Tammemagi MC, Mayo JR, Roberts H, Liu G, Soghrati K, Yasufuku K, Martel S, Laberge F, Gingras M, Atkar-Khattra S, Berg CD, Evans K, Finley R, Yee J, English J, Nasute P, Goffin J, Puksa S, Stewart L, Tsai S, Johnston MR, Manos D, Nicholas G, Goss GD, Seely JM, Amjadi K, Tremblay A, Burrowes P, MacEachern P, Bhatia R, Tsao MS, Lam S. Probability of cancer in pulmonary nodules detected on first screening CT. N Engl J Med 2013; 369:910-9. [PMID: 24004118 PMCID: PMC3951177 DOI: 10.1056/nejmoa1214726] [Citation(s) in RCA: 862] [Impact Index Per Article: 78.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Major issues in the implementation of screening for lung cancer by means of low-dose computed tomography (CT) are the definition of a positive result and the management of lung nodules detected on the scans. We conducted a population-based prospective study to determine factors predicting the probability that lung nodules detected on the first screening low-dose CT scans are malignant or will be found to be malignant on follow-up. METHODS We analyzed data from two cohorts of participants undergoing low-dose CT screening. The development data set included participants in the Pan-Canadian Early Detection of Lung Cancer Study (PanCan). The validation data set included participants involved in chemoprevention trials at the British Columbia Cancer Agency (BCCA), sponsored by the U.S. National Cancer Institute. The final outcomes of all nodules of any size that were detected on baseline low-dose CT scans were tracked. Parsimonious and fuller multivariable logistic-regression models were prepared to estimate the probability of lung cancer. RESULTS In the PanCan data set, 1871 persons had 7008 nodules, of which 102 were malignant, and in the BCCA data set, 1090 persons had 5021 nodules, of which 42 were malignant. Among persons with nodules, the rates of cancer in the two data sets were 5.5% and 3.7%, respectively. Predictors of cancer in the model included older age, female sex, family history of lung cancer, emphysema, larger nodule size, location of the nodule in the upper lobe, part-solid nodule type, lower nodule count, and spiculation. Our final parsimonious and full models showed excellent discrimination and calibration, with areas under the receiver-operating-characteristic curve of more than 0.90, even for nodules that were 10 mm or smaller in the validation set. CONCLUSIONS Predictive tools based on patient and nodule characteristics can be used to accurately estimate the probability that lung nodules detected on baseline screening low-dose CT scans are malignant. (Funded by the Terry Fox Research Institute and others; ClinicalTrials.gov number, NCT00751660.).
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689
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Galvin JR, Franks TJ. Lung cancer diagnosis: radiologic imaging, histology, and genetics. Radiology 2013; 268:9-11. [PMID: 23793588 DOI: 10.1148/radiol.13130558] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Jeffrey R Galvin
- Department of Diagnostic Radiology, University of Maryland School of Medicine, UMH N2W78, 655 W Baltimore St, Baltimore, MD 2120, USA.
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690
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Abstract
Deaths from lung cancer exceed those from any other type of malignancy, with 1·5 million deaths in 2010. Prevention and smoking cessation are still the main methods to reduce the death toll. The US National Lung Screening Trial, which compared CT screening with chest radiograph, yielded a mortality advantage of 20% to participants in the CT group. International debate is ongoing about whether sufficient evidence exists to implement CT screening programmes. When questions about effectiveness and cost-effectiveness have been answered, which will await publication of the largest European trial, NELSON, and pooled analysis of European CT screening trials, we discuss the main topics that will need consideration. These unresolved issues are risk prediction models to identify patients for CT screening; radiological protocols that use volumetric analysis for indeterminate nodules; options for surgical resection of CT-identified nodules; screening interval; and duration of screening. We suggest that a demonstration project of biennial screening over a 4-year period should be undertaken.
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Affiliation(s)
- John K Field
- Roy Castle Lung Cancer Research Programme, Department of Molecular and Clinical Cancer Medicine, The University of Liverpool Cancer Research Centre, Liverpool, UK.
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691
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Dong M, Xu S, Wu Y, Liu Y, Chen G, Chen J. [Lung adenocarcinoma in situ which CT showed single pure ground-glass opacity: a case report and literature review]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2013; 16:438-40. [PMID: 23945249 PMCID: PMC6000668 DOI: 10.3779/j.issn.1009-3419.2013.08.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Ming Dong
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300053, China
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Pass HI. Lung cancer, histologic stratification, and resection extent: something for surgeons to think about. J Natl Cancer Inst 2013; 105:1168-9. [PMID: 23926068 DOI: 10.1093/jnci/djt197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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693
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Vansteenkiste J, De Ruysscher D, Eberhardt WEE, Lim E, Senan S, Felip E, Peters S. Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; 24 Suppl 6:vi89-98. [PMID: 23860613 DOI: 10.1093/annonc/mdt241] [Citation(s) in RCA: 383] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- J Vansteenkiste
- Respiratory Oncology (Pulmonology), University Hospitals Leuven/KU Leuven, Leuven
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694
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Powell CA, Halmos B, Nana-Sinkam SP. Update in lung cancer and mesothelioma 2012. Am J Respir Crit Care Med 2013; 188:157-66. [PMID: 23855692 PMCID: PMC3778761 DOI: 10.1164/rccm.201304-0716up] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 06/01/2013] [Indexed: 12/21/2022] Open
Affiliation(s)
- Charles A Powell
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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695
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Patel VK, Naik SK, Naidich DP, Travis WD, Weingarten JA, Lazzaro R, Gutterman DD, Wentowski C, Grosu HB, Raoof S. A practical algorithmic approach to the diagnosis and management of solitary pulmonary nodules: part 2: pretest probability and algorithm. Chest 2013; 143:840-846. [PMID: 23460161 DOI: 10.1378/chest.12-1487] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
In this second part of a two-part series, we describe an algorithmic approach to the diagnosis of the solitary pulmonary nodule (SPN). An essential aspect of the evaluation of SPN is determining the pretest probability of malignancy, taking into account the significant medical history and social habits of the individual patient, as well as morphologic characteristics of the nodule. Because pretest probability plays an important role in determining the next step in the evaluation, we describe various methods the physician may use to make this determination. Subsequently, we outline a simple yet comprehensive algorithm for diagnosing a SPN, with distinct pathways for the solid and subsolid SPN.
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696
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Gao F, Li M, Ge X, Zheng X, Ren Q, Chen Y, Lv F, Hua Y. Multi-detector spiral CT study of the relationships between pulmonary ground-glass nodules and blood vessels. Eur Radiol 2013; 23:3271-7. [DOI: 10.1007/s00330-013-2954-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Revised: 06/06/2013] [Accepted: 06/07/2013] [Indexed: 12/21/2022]
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697
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Prosch H, Schaefer-Prokop C. Radiologische Abklärung inzidenteller pulmonaler Rundherde. Radiologe 2013; 53:623-36; 637-8. [DOI: 10.1007/s00117-013-2530-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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698
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Arenas-Jiménez J. Measurement of Solid Component in Part-Solid Lesions with a Mediastinal Window Setting? Radiology 2013; 268:305-6. [DOI: 10.1148/radiol.13130209] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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699
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700
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[Research progress of treatment strategy for pulmonary nodule]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2013; 16:261-6. [PMID: 23676983 PMCID: PMC6000607 DOI: 10.3779/j.issn.1009-3419.2013.05.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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