Purpose
Using data and images from the National Lung Screening Trial (NLST), we extracted radiological features from small pulmonary nodules (SPNs) that did not meet the original criteria to be considered a positive screen and identified features associated with lung cancer risk.
Methods
We extracted radiological features from SPNs of baseline low-dose computed tomography screens that did not meet NLST criteria to be considered a positive screen. SPNs were identified for 73 incidence case patients that were diagnosed with lung cancer at either the first or second follow-up screen and for 157 control subjects who had had three consecutive negative screens. Multivariable logistic regression was used to assess the association between radiological features and lung cancer risk. All statistical tests were two-sided.
Results
Nine features were significantly different between case patients and control subjects. Backward-elimination followed by bootstrap re-sampling identified a reduced model of highly informative radiological features with an under the ROC curve of 0.932 (95% C] 0.88–0.96), specificity of 92.38% (95% CI 52.22–84.91), and sensitivity of 76.55% (95% CI 87.50–95.35) that included total emphysema score (OR=1.71; 95% CI 1.39–2.01), attachment to vessel (OR=2.41; 95% CI 0.99–5.81), nodule location (OR=3.25; 95% CI 1.09–8.55), border definition (OR=7.56; 95% CI 1.89–30.8), and concavity (OR=2.58; 95% CI 0.89–5.64).
Conclusion
We identified a set of clinically relevant radiological features that that can be easily scored in the clinical setting and may be of use to determine lung cancer risk among participants presenting with SPNs.
ATA sonographic patterns are associated with distinct clinical features and pathological outcomes, and effectively stratify the cancer risk in ITNs. Thus, the ATA sonographic patterns should be used not only to set the size threshold for biopsy, but also to personalize management after the biopsy.
Object
Hereditary hemorrhagic telangiectasia (HHT) is a hereditary disorder characterized by mucocutaneous telangiectasias, frequent nosebleeds, and visceral arteriovenous malformations (AVMs). Few reports have outlined the prevalence of the various cerebral vascular malformations found in patients with HHT. The authors set out to define the prevalence of cerebral vascular malformations in a population of HHT patients who underwent imaging with 3-T imaging (MRI/MR angiography [MRA]) of the brain.
Methods
A retrospective review of prospectively collected data was carried out using a database of 372 HHT patients who were seen and examined at the Georgia Regents University HHT Center and screened with 3-T MRI/MRA. Data were tabulated for numbers and types of vascular malformations in this population.
Results
Arteriovenous malformations were identified in 7.7%, developmental venous anomalies in 4.3%, and cerebral aneurysms in 2.4% of HHT patients. The HHT AVMs tended to be supratentorial, small, and cortical in this series, findings consistent with other recent studies in the literature. An arteriovenous fistula, cavernous malformation, and capillary telangiectasia were identified in 0.5%, 1%, and 1.9% of HHT patients, respectively.
Conclusions
Few studies have investigated the prevalence of the various vascular malformations found in HHT patients screened with 3-T MRI/MRA of the brain. Hereditary hemorrhagic telangiectasia AVMs are more likely to be multiple and have a tendency toward small size and cortical location. As such, they are often treated using a single-modality therapy.
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