OBJECTIVE: In the Early Lung Cancer Action Project (ELCAP), we found not only solid but also part-solid and nonsolid nodules in patients at both baseline and repeat CT screening for lung cancer. We report the frequency and significance of part-solid and nonsolid nodules in comparison with solid nodules. MATERIALS AND METHODS: We reviewed all instances of a positive finding in patients at baseline (from one to six noncalcified nodules) and annual repeat screenings (from one to six newly detected noncalcified nodules with interim growth) to classify each of the nodules as solid, part-solid, or nonsolid. We defined a solid nodule as a nodule that completely obscures the entire lung parenchyma within it. Part-solid nodules are those having sections that are solid in this sense, and nonsolid nodules are those with no solid parts. Chi-square statistics were used to test for differences in the malignancy rates. RESULTS: Among the 233 instances of positive results at baseline screening, 44 (19%) involved a part-solid or nonsolid largest nodule (16 part-solid and 28 nonsolid). Among these 44 cases of positive findings, malignancy was diagnosed in 15 (34%) as opposed to a 7% malignancy rate for solid nodules (p = 0.000001). The malignancy rate for part-solid nodules was 63% (10/16), and the rate for nonsolid nodules was 18% (5/28). Even after standardizing for nodule size, the malignancy rate was significantly higher for part-solid nodules than for either solid ones (p = 0.004) or nonsolid ones (p = 0.03). The malignancy type in the part-solid or nonsolid nodules was predominantly bronchioloalveolar carcinoma or adenocarcinoma with bronchioloalveolar features, contrasting with other subtypes of adenocarcinoma found in the solid nodules (p = 0.0001). At annual repeat screenings, only 30 instances of positive test results have been obtained; seven of these involved part-solid or nonsolid nodules. CONCLUSION: In CT screening for lung cancer, the detected nodule commonly is either only part-solid or nonsolid, but such a nodule is more likely to be malignant than a solid one, even when nodule size is taken into account.
OBJECTIVE: In the Early Lung Cancer Action Project (ELCAP), we found not only solid but also part-solid and nonsolid nodules in patients at both baseline and repeat CT screening for lung cancer. We report the frequency and significance of part-solid and nonsolid nodules in comparison with solid nodules. MATERIALS AND METHODS: We reviewed all instances of a positive finding in patients at baseline (from one to six noncalcified nodules) and annual repeat screenings (from one to six newly detected noncalcified nodules with interim growth) to classify each of the nodules as solid, part-solid, or nonsolid. We defined a solid nodule as a nodule that completely obscures the entire lung parenchyma within it. Part-solid nodules are those having sections that are solid in this sense, and nonsolid nodules are those with no solid parts. Chi-square statistics were used to test for differences in the malignancy rates. RESULTS: Among the 233 instances of positive results at baseline screening, 44 (19%) involved a part-solid or nonsolid largest nodule (16 part-solid and 28 nonsolid). Among these 44 cases of positive findings, malignancy was diagnosed in 15 (34%) as opposed to a 7% malignancy rate for solid nodules (p = 0.000001). The malignancy rate for part-solid nodules was 63% (10/16), and the rate for nonsolid nodules was 18% (5/28). Even after standardizing for nodule size, the malignancy rate was significantly higher for part-solid nodules than for either solid ones (p = 0.004) or nonsolid ones (p = 0.03). The malignancy type in the part-solid or nonsolid nodules was predominantly bronchioloalveolar carcinoma or adenocarcinoma with bronchioloalveolar features, contrasting with other subtypes of adenocarcinoma found in the solid nodules (p = 0.0001). At annual repeat screenings, only 30 instances of positive test results have been obtained; seven of these involved part-solid or nonsolid nodules. CONCLUSION: In CT screening for lung cancer, the detected nodule commonly is either only part-solid or nonsolid, but such a nodule is more likely to be malignant than a solid one, even when nodule size is taken into account.
Authors: Marjolein A Heuvelmans; Matthijs Oudkerk; Pim A de Jong; Willem P Mali; Harry J M Groen; Rozemarijn Vliegenthart Journal: Eur Radiol Date: 2014-11-04 Impact factor: 5.315
Authors: Dag Wormanns; Gerhard Kohl; Ernst Klotz; Anke Marheine; Florian Beyer; Walter Heindel; Stefan Diederich Journal: Eur Radiol Date: 2003-11-13 Impact factor: 5.315
Authors: Jong Hyuk Lee; Chang Min Park; Sang Min Lee; Hyungjin Kim; H Page McAdams; Jin Mo Goo Journal: Eur Radiol Date: 2015-09-18 Impact factor: 5.315
Authors: Ying Liu; Yoganand Balagurunathan; Thomas Atwater; Sanja Antic; Qian Li; Ronald C Walker; Gary T Smith; Pierre P Massion; Matthew B Schabath; Robert J Gillies Journal: Clin Cancer Res Date: 2016-09-23 Impact factor: 12.531
Authors: Madeline Vazquez; Darryl Carter; Elizabeth Brambilla; Adi Gazdar; Masayuki Noguchi; William D Travis; Yao Huang; Lijuan Zhang; Rowena Yip; David F Yankelevitz; Claudia I Henschke Journal: Lung Cancer Date: 2008-10-31 Impact factor: 5.705