Marjolein A Heuvelmans1, Rozemarijn Vliegenthart2, Harry J de Koning3, Harry J M Groen4, Michel J A M van Putten5, Uraujh Yousaf-Khan6, Carla Weenink7, Kristiaan Nackaerts8, Pim A de Jong9, Matthijs Oudkerk10. 1. University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; Department of Pulmonology, Medisch Spectrum Twente, Koningsplein 1, 7512 KZ Enschede, The Netherlands. Electronic address: m.a.heuvelmans@umcg.nl. 2. University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Electronic address: r.vliegenthart@umcg.nl. 3. Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000CA Rotterdam, The Netherlands. Electronic address: h.dekoning@erasmusmc.nl. 4. University of Groningen, University Medical Center Groningen, Department of Pulmonology, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Electronic address: h.j.m.groen@umcg.nl. 5. Department of Clinical Neurophysiology, MIRA, Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands; Department of Neurology and Clinical Neurophysiology, Medisch Spectrum Twente, Koningsplein 1, 7512 KZ Enschede, The Netherlands. Electronic address: m.vanputten@mst.nl. 6. Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000CA Rotterdam, The Netherlands. Electronic address: a.yousaf@erasmusmc.nl. 7. Department of Pulmonary Medicine, Kennemer Gasthuis, Boerhaavelaan 22, 2035 RC Haarlem, The Netherlands. Electronic address: weenink@kg.nl. 8. Department of Pulmonary Medicine, KU Leuven - University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium. Electronic address: kristiaan.nackaerts@zuleuven.be. 9. Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Electronic address: pimdejong@gmail.com. 10. University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. Electronic address: m.oudkerk@umcg.nl.
Abstract
OBJECTIVES: Although exponential growth is assumed for lung cancer, this has never been quantified in vivo. Aim of this study was to evaluate and quantify growth patterns of lung cancers detected in the Dutch-Belgian low-dose computed tomography (CT) lung cancer screening trial (NELSON), in order to elucidate the development and progression of early lung cancer. MATERIALS AND METHODS: Solid lung nodules found at ≥3 CT examinations before lung cancer diagnosis were included. Lung cancer volume (V) growth curves were fitted with a single exponential, expressed as V=V1 exp(t/τ), with t time from baseline (days), V1 estimated baseline volume (mm3), and τ estimated time constant. The R2 coefficient of determination was used to evaluate goodness of fit. Overall volume-doubling time for the individual lung cancer is given by τ*log(2). RESULTS: Forty-seven lung cancers in 46 participants were included. Forty participants were male (87.0%); mean age was 61.7 years (standard deviation, 6.2 years). Median nodule size at baseline was 99.5mm3 (IQR: 46.8-261.8mm3). Nodules were followed for a median of 770 days (inter-quartile range: 383-1102 days) before lung cancer diagnosis. One cancer (2.1%) was diagnosed after six CT examinations, six cancers (12.8%) were diagnosed after five CTs, 14 (29.8%) after four CTs, and 26 cancers (55.3%) after three CTs. Lung cancer growth could be described by an exponential function with excellent goodness of fit (R2 0.98). Median overall volume-doubling time was 348 days (inter-quartile range: 222-492 days). CONCLUSION: This study based on CT lung cancer screening provides in vivo evidence that growth of cancerous small-to-intermediate sized lung nodules detected at low-dose CT lung cancer screening can be described by an exponential function such as volume-doubling time.
OBJECTIVES: Although exponential growth is assumed for lung cancer, this has never been quantified in vivo. Aim of this study was to evaluate and quantify growth patterns of lung cancers detected in the Dutch-Belgian low-dose computed tomography (CT) lung cancer screening trial (NELSON), in order to elucidate the development and progression of early lung cancer. MATERIALS AND METHODS: Solid lung nodules found at ≥3 CT examinations before lung cancer diagnosis were included. Lung cancer volume (V) growth curves were fitted with a single exponential, expressed as V=V1 exp(t/τ), with t time from baseline (days), V1 estimated baseline volume (mm3), and τ estimated time constant. The R2 coefficient of determination was used to evaluate goodness of fit. Overall volume-doubling time for the individual lung cancer is given by τ*log(2). RESULTS: Forty-seven lung cancers in 46 participants were included. Forty participants were male (87.0%); mean age was 61.7 years (standard deviation, 6.2 years). Median nodule size at baseline was 99.5mm3 (IQR: 46.8-261.8mm3). Nodules were followed for a median of 770 days (inter-quartile range: 383-1102 days) before lung cancer diagnosis. One cancer (2.1%) was diagnosed after six CT examinations, six cancers (12.8%) were diagnosed after five CTs, 14 (29.8%) after four CTs, and 26 cancers (55.3%) after three CTs. Lung cancer growth could be described by an exponential function with excellent goodness of fit (R2 0.98). Median overall volume-doubling time was 348 days (inter-quartile range: 222-492 days). CONCLUSION: This study based on CT lung cancer screening provides in vivo evidence that growth of cancerous small-to-intermediate sized lung nodules detected at low-dose CT lung cancer screening can be described by an exponential function such as volume-doubling time.
Authors: Onno M Mets; Kaman Chung; Pieter Zanen; Ernst T Scholten; Wouter B Veldhuis; Bram van Ginneken; Mathias Prokop; Cornelia M Schaefer-Prokop; Pim A de Jong Journal: Eur Respir J Date: 2018-04-12 Impact factor: 16.671
Authors: Nathan Mynard; Ashish Saxena; Alexandra Mavracick; Jeffrey Port; Benjamin Lee; Sebron Harrison; Oliver Chow; Jonathan Villena-Vargas; Ronald Scheff; Giuseppe Giaccone; Nasser Altorki Journal: Clin Lung Cancer Date: 2021-08-29 Impact factor: 4.840