Incidental findings in Lung Cancer Screening: Which ones are Relevant?
Recently there has been an increasing interest in the potential benefits of lung cancer screening due to the diagnosis and earlier treatment of unsuspected diseases in screening participants. In this regard, besides there being a significant (20%) reduction in the lung cancer specific mortality rate in the National Lung Cancer Screening Trial (NLST), there was a 6.7% reduction in all-cause mortality (ACM) in participants screened with annual low dose computed tomography (LDCT).1 The decrease in ACM can be partly attributable to the detection and treatment of incidental finding (IFs) such as coronary artery calcification (C...
Source: Seminars in Roentgenology - June 6, 2017 Category: Radiology Authors: Myrna C.B. Godoy, Helena A.C. Pereira, Brett W. Carter, Carol C. Wu, Jeremy J. Erasmus Source Type: research
Spectrum of Subsolid Pulmonary Nodules and Overdiagnosis
Low-dose computed tomography (LDCT) for lung cancer screening is currently recommended by medical organizations in the United States and the US Preventative Services Task Force.1-3 Subsolid pulmonary nodules continue to present a significant challenge in terms of detection and management on chest CT. Albeit they can represent acute inflammatory lesions, subsolid nodules are highly associated with the spectrum of lung adenocarcinoma,2,4-8 ranging from preinvasive to invasive, with varying clinical behaviors that hinder their characterization and management. (Source: Seminars in Roentgenology)
Source: Seminars in Roentgenology - June 5, 2017 Category: Radiology Authors: Barry D. Hutchinson, Andre L. Moreira, Jane P. Ko Source Type: research
Role of Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in the Evaluation of Suspicious Pulmonary Nodules
The prevalence of noncalcified pulmonary nodules in smokers or former smokers is between 23% and 69% based on findings from the Early Lung Cancer Action Project and a lung cancer screening trial conducted at the Mayo Clinic, respectively; however, only 2.7% of these nodules were malignant in the former and only 2.6% of patients in the latter were diagnosed with lung cancer.1,2 In the National Lung Screening Trial (NLST), the rate of low-dose CT (LDCT) examinations with a noncalcified nodule measuring at least 4mm (positive screen) was 24.2% yet 96.4% of these nodules were false positives. (Source: Seminars in Roentgenology)
Source: Seminars in Roentgenology - June 5, 2017 Category: Radiology Authors: Brett W. Carter, John P. Lichtenberger, Girish S. Shroff, Mylene T. Truong, Carol C. Wu Source Type: research
Sampling of Suspicious Solitary Pulmonary Nodules: Percutaneous Needle Biopsy and Preoperative Localization
Indeterminate pulmonary nodules detected with low-dose computed tomography during lung cancer screening may be referred for a tissue diagnosis. Although bronchoscopy is the initial investigation of choice for the evaluation of airspace opacities and hilar masses, screen-detected nodules are more likely small and peripheral and therefore less accessible by bronchoscopy.1 Radiologists with experience in thoracic intervention have an important role in the workup of suspicious screen-detected nodules. (Source: Seminars in Roentgenology)
Source: Seminars in Roentgenology - June 5, 2017 Category: Radiology Authors: Florian J. Fintelmann, Amita Sharma Source Type: research
Lung Computed Tomography Screening Reporting and Data System Version 1.0
The National Lung Screening Trial (NLST) demonstrated that screening for lung cancer with low-dose computed tomography (LDCT) results in a 20% reduction of lung cancer-specific mortality in high-risk patients.1 The US Preventive Services Task Force recommends annual screening with LDCT for adults 55-80 years of age who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years.2 Similar eligibility criteria have been proposed by the Centers for Medicare and Medicaid Services although a narrower patient age range of 55-77 years is employed. (Source: Seminars in Roentgenology)
Source: Seminars in Roentgenology - June 5, 2017 Category: Radiology Authors: Brett W. Carter, John P. Lichtenberger, Girish S. Shroff, Carol C. Wu Source Type: research
Elements of a Lung Cancer Screening program
Lung cancer screening (LCS) with low-dose CT (LDCT) has been endorsed by the United States Preventive Services Task Force (USPSTF) and the Centers for Medicare and Medicaid Services (CMS).1,2 As a result, imaging facilities in all settings must develop the capability to organize and administer such screening programs. (Source: Seminars in Roentgenology)
Source: Seminars in Roentgenology - June 5, 2017 Category: Radiology Authors: Florian J. Fintelmann Source Type: research
Role of FDG PET/CT in the Evaluation of Suspicious Pulmonary Nodules
The prevalence of non-calcified pulmonary nodules in smokers or former smokers is between 23% and 69% based on findings from the Early Lung Cancer Action Project and a lung cancer screening trial conducted at the Mayo Clinic, respectively; however, only 2.7% of these nodules were malignant in the former and only 2.6% of patients in the latter were diagnosed with lung cancer.1,2 In the National Lung Screening Trial (NLST), the rate of low-dose CT examinations with a non-calcified nodule measuring at least 4mm (positive screen) was 24.2% yet 96.4% of these nodules were false positives. (Source: Seminars in Roentgenology)
Source: Seminars in Roentgenology - June 5, 2017 Category: Radiology Authors: Brett W. Carter, John P. Lichtenberger, Girish Shroff, Mylene T. Truong, Carol C. Wu Tags: Issue 52/3 - July Lung cancer screening Source Type: research
Lung-RADS Version 1.0
The National Lung Screening Trial (NLST) demonstrated that screening for lung cancer with low-dose computed tomography (LDCT) results in a 20% reduction of lung cancer-specific mortality in high-risk patients.1 The U.S. Preventive Services Task Force (USPSTF) recommends annual screening with LDCT for adults 55 –80 years of age who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years.2 Similar eligibility criteria have been proposed by the Centers for Medicare and Medicaid Services (CMS) although a narrower patient age range of 55–77 years is employed. (Source: Seminars in Roentgenology)
Source: Seminars in Roentgenology - June 5, 2017 Category: Radiology Authors: Brett W. Carter, John P. Lichtenberger, Girish Shroff, Carol C. Wu Source Type: research
Sampling of suspicious solitary pulmonary nodules: Percutaneous needle biopsy and pre-operative localization
Indeterminate pulmonary nodules detected with low-dose CT (LDCT) during lung cancer screening (LCS) may be referred for a tissue diagnosis. While bronchoscopy is the initial investigation of choice for the evaluation of airspace opacities and hilar masses, screen-detected nodules are more likely small and peripheral and therefore less accessible by bronchoscopy.1 Radiologists with experience in thoracic intervention have an important role in the workup of suspicious screen-detected nodules.2,3 This includes image-guided percutaneous transthoracic needle biopsy (PTNB) for low to moderate risk nodules and pre-operative image...
Source: Seminars in Roentgenology - June 5, 2017 Category: Radiology Authors: Florian J. Fintelmann, Amita Sharma Source Type: research
Spectrum of Subsolid Pulmonary Nodules and Overdiagnsis
Low-dose computed tomography (LDCT) for lung cancer screening is currently recommended by medical organizations in the United States (US) and the US Preventative Services Task Force.1 –3 Subsolid pulmonary nodules continue to present a significant challenge in terms of detection and management on chest CT. Albeit they can represent acute inflammatory lesions, subsolid nodules are highly associated with the spectrum of lung adenocarcinoma,2,4–8 ranging from preinvasive to inva sive, with varying clinical behaviors that hinder their characterization and management. (Source: Seminars in Roentgenology)
Source: Seminars in Roentgenology - June 5, 2017 Category: Radiology Authors: Barry D. Hutchinson, Andre L. Moreira, Jane P. Ko Source Type: research
Low-Dose Computed Tomography for Lung Cancer Screening: The Protocol and The Dose
The National Lung Screening Trial (NLST) reported a 20% reduction in lung cancer mortality using low-dose computed tomography (LDCT) for lung cancer screening.1 Since its publication in 2011, the US Preventive Services Task Force has recommended,2 and the US Centers for Medicare& Medicaid Services3 has approved the use of LDCT for lung cancer screening for appropriate high-risk patients. (Source: Seminars in Roentgenology)
Source: Seminars in Roentgenology - June 3, 2017 Category: Radiology Authors: Shaunagh McDermott, Mannudeep K. Kalra Source Type: research
The Role of Liquid Biopsies in Lung Cancer Screening
Lung cancer is the leading cause of cancer-related mortality in the United States.1 For the majority of lung cancer patients, a current or former smoking history puts them at higher risk for cancer.2 As patients are most often diagnosed after they have developed symptoms from advanced disease, the overall 5-year survival rate for lung cancer is only 20%.3,4 However, when the group of patients presenting with metastatic disease is compared to those with localized lung cancer, survival at 5 years increases from less than 5% to approximately 60%. (Source: Seminars in Roentgenology)
Source: Seminars in Roentgenology - June 3, 2017 Category: Radiology Authors: Ibiayi Dagogo-Jack, Lecia V. Sequist, Zofia Piotrowska Tags: Issue 52/3 - July Lung cancer screening Source Type: research
Low Dose CT for Lung Cancer Screening: The Protocol and The Dose
The National Lung Screening Trial (NLST) reported a 20% reduction in lung cancer mortality using low-dose computed tomography (LDCT) for lung cancer screening.1 Since its publication in 2011, the U.S. Preventive Services Task Force has recommended,2 and the U.S. Centers for Medicare& Medicaid Services (CMS) 3 has approved the use of LDCT for lung cancer screening for appropriate high-risk patients. (Source: Seminars in Roentgenology)
Source: Seminars in Roentgenology - June 3, 2017 Category: Radiology Authors: Shaunagh McDermott, Mannudeep K. Kalra Tags: Issue 52/3 - July Lung cancer screening Source Type: research
Sampling of suspicious solitary pulmonary nodules: electromagnetic navigational bronchoscopy and video-assisted thorascopic surgery
In an era of increasing utilization of chest imaging particularly for lung cancer screening, solitary pulmonary nodules are more prevalent; however, most nodules are not malignant. The National Lung Screening Trial (NLST), which demonstrated that screening with low-dose CT resulted in a 20% relative reduction in the rate of death from lung cancer,1 found that about 24% of patients undergoing low-dose CT had a positive screening result. Of these, 90% of patients underwent further diagnostic workup, including further imaging (81%), bronchoscopy (4.3%), surgical procedure (4.2%) or percutaneous biopsy (2.2%). (Source: Seminars in Roentgenology)
Source: Seminars in Roentgenology - June 3, 2017 Category: Radiology Authors: Maria Lucia L. Madariaga, Michael Lanuti Source Type: research
Managing Patients with Screen-Detected Nodules: The Nodule Clinic
Lung cancer screening with low-dose computed tomography (LDCT) has become a public health recommendation since the publication of the national lung screening trial (NLST) in 2011.1,2 This landmark trial showed a significant decrease in lung cancer specific mortality as a result of screening with LDCT compared to chest radiography. The number of lung screening programs throughout the country has since markedly increased.3 The configuration of lung screening programs can vary significantly between institutions, healthcare systems and regions. (Source: Seminars in Roentgenology)
Source: Seminars in Roentgenology - June 3, 2017 Category: Radiology Authors: Meghan J. Campo, Inga T. Lennes Source Type: research
