Literature DB >> 18984780

Smooth or attached solid indeterminate nodules detected at baseline CT screening in the NELSON study: cancer risk during 1 year of follow-up.

Dong Ming Xu1, Hester J van der Zaag-Loonen, Matthijs Oudkerk, Ying Wang, Rozemarijn Vliegenthart, Ernst T Scholten, Johny Verschakelen, Mathias Prokop, Harry J de Koning, Rob J van Klaveren.   

Abstract

PURPOSE: To retrospectively determine whether baseline nodule characteristics at 3-month and 1-year volume doubling time (VDT) are predictive for lung cancer in solid indeterminate noncalcified nodules (NCNs) detected at baseline computed tomographic (CT) screening.
MATERIALS AND METHODS: The study, conducted between April 2004 and May 2006, was institutional review board approved. Patient consent was waived for this retrospective evaluation. NCNs between 5 and 10 mm in diameter (n = 891) were evaluated at 3 months and 1 year to assess growth (VDT < 400 days). Baseline assessments were related to growth at 3 months and 1 year by using chi(2) and Mann-Whitney U tests. Baseline assessments and growth were related to the presence of malignancy by using univariate and multivariate logistic regression analyses.
RESULTS: At 3 months and at 1 year, 8% and 1% of NCNs had grown, of which 15% and 50% were malignant, respectively. One-year growth was related to morphology (P < .01), margin (P < .0001), location (P < .001), and size (P < .01). All cancers were nonspherical and purely intraparenchymal, without attachment to vessels, the pleura, or fissures. In nonsmooth unattached nodules, a volume of 130 mm(3) or larger was the only predictor for malignancy (odds ratio, 6.3; 95% confidence interval [CI]: 1.7, 23.0). After the addition of information on the 3-month VDT, large volume (odds ratio, 4.9; 95% CI: 1.2, 20.1) and 3-month VDT (odds ratio, 15.6; 95% CI: 4.5, 53.5) helped predict malignancy. At 1 year, only the 1-year growth remained (odds ratio, 213.3; 95% CI: 18.7, 2430.9) as predictor for malignancy.
CONCLUSION: In smooth or attached solid indeterminate NCNs, no malignancies were found at 1-year follow-up. In nonsmooth purely intraparenchymal NCNs, size is the main baseline predictor for malignancy. When follow-up data are available, growth is a strong predictor for malignancy, especially at 1-year follow-up. (c) RSNA, 2008.

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Year:  2008        PMID: 18984780     DOI: 10.1148/radiol.2493070847

Source DB:  PubMed          Journal:  Radiology        ISSN: 0033-8419            Impact factor:   11.105


  41 in total

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Review 5.  [Characterization and management of incidentally detected solitary pulmonary nodules].

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Review 7.  European and North American lung cancer screening experience and implications for pulmonary nodule management.

Authors:  Arjun Nair; David M Hansell
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8.  A mathematical simulation to assess variability in lung nodule size measurement associated with nodule-slice position.

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9.  Lung nodule volumetry: segmentation algorithms within the same software package cannot be used interchangeably.

Authors:  H Ashraf; B de Hoop; S B Shaker; A Dirksen; K S Bach; H Hansen; M Prokop; J H Pedersen
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10.  The PROgnostic Value of unrequested Information in Diagnostic Imaging (PROVIDI) Study: rationale and design.

Authors:  M J A Gondrie; W P Th M Mali; C F M Buckens; P C A Jacobs; D E Grobbee; Y van der Graaf
Journal:  Eur J Epidemiol       Date:  2010-10-02       Impact factor: 8.082

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