CT Screening for Lung Cancer: Part-Solid Nodules in Baseline and Annual Repeat Rounds

Henschke, Claudia I.; Yip, Rowena; Smith, James P.; Wolf, Andrea; Flores, Raja M.; Liang, Mingzhu; Salvatore, Mary M.; Liu, Ying; Xu, Dong; Yankelevitz, David F.

doi:10.2214/ajr.16.16043

Cited by 101 publications

(97 citation statements)

References 30 publications

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“…Solid nodules may have external or internal cystic airspace or internal cavitation (15). Subsolid nodules may be either nonsolid or part-solid (7,19,20). A part-solid nodule is one that has internal components that completely obscure the lung parenchyma, and non-solid if none of the lung parenchyma is completely obscured.…”

Section: Definition Of Nodule Consistencymentioning

confidence: 99%

“…The workup of subsolid nodules should be based on the size of the largest solid component (19,20,(26)(27)(28). This recommendation is based on the radiologic findings as well as the pathology findings.…”

Section: Definition Of Nodule Consistencymentioning

confidence: 99%

“…For all individuals in whom the work-up was stopped or the biopsy did not lead to a diagnosis of lung cancer, repeat CT 12 months after the prior screening is to be performed and the progression cannot be verified, the nodule should be classified as solid (20).…”

Section: Definition Of Nodule Consistencymentioning

confidence: 99%

“…It has been shown that some solid and many subsolid nodules identified in the lung parenchyma will resolve, particularly new ones identified on repeat screenings (19,20). Thus, follow-up imaging three [3] months after baseline or one [1] month after annual repeat screening is useful to avoid unnecessary further diagnostics, especially invasive ones.…”

Section: Probability Of Lung Cancer By Nodule Size and Consistencymentioning

confidence: 99%

“…Starting with the initial protocol developed for CT screening for lung cancer in 1992 (2-4), the protocol has been continuously updated based on the results of conferences held every 6 months (5,6) and on subsequent data emerging from CT screening (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). The protocol has been recently updated, integrating the latest technologies advances and knowledge (21).…”

Section: Introductionmentioning

confidence: 99%

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The importance of the regimen of screening in maximizing the benefit and minimizing the harms

Henschke¹,

Li²,

Yip³

et al. 2016

Ann. Transl. Med.

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Background: In CT screening for lung cancer, the regimen of screening is critical in diagnosing lung cancer early while limiting unnecessary tests and invasive procedures. The International Early Lung Cancer Action Program (I-ELCAP) has developed a regimen based on evidence collected in the I-ELCAP cohort of more than 70,000 participants.Methods: Important in the development of the regimen is the recognition of the profound difference between the first, baseline round of screening and all subsequent rounds of repeat screening. For each person undergoing screening, the baseline round happens only once while repeat rounds will be performed annually for many years.This difference needs to be clearly recognized as it is these annual rounds which allow for identification of small, early, yet aggressive, lung cancers which have high cure rates despite their aggressiveness. The importance of nodule consistency and size are key factors in the regimen. The regimen needs to be continuously updated by incorporating advances in technology and knowledge.Results: The use of the I-ELCAP regimen reduces the workup of participants in the screening program to less than 10% in the baseline round and less than 6% in the annual repeat rounds. By use of this regimen, estimated cure rate of lung cancers diagnosed under screening is 80% or higher in both baseline and annual repeat rounds. Conclusions:The I-ELCAP collaboration provides a new paradigm that answers the 2002 NCI call for multiple approaches to address relevant questions about screening and the Institute of Medicine (IOM) Roundtable on Evidence-based Medicine from the National Academy of Science's call for a "new clinical research paradigm that takes better advantage of data generated in the course of healthcare delivery would speed and improve the development of evidence for real-world decision making".

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Section: Definition Of Nodule Consistencymentioning

confidence: 99%

Section: Definition Of Nodule Consistencymentioning

confidence: 99%

Section: Definition Of Nodule Consistencymentioning

confidence: 99%

Section: Probability Of Lung Cancer By Nodule Size and Consistencymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The importance of the regimen of screening in maximizing the benefit and minimizing the harms

Henschke¹,

Li²,

Yip³

et al. 2016

Ann. Transl. Med.

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Screening for Lung Cancer With Low-Dose Computed Tomography

Jonas

Reuland

Reddy

et al. 2021

JAMA

335

231

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Cancer of the Lung

Morgensztern¹,

Boffa²,

Chen³

et al. 2022

Holland‐Frei Cancer Medicine

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Overview Lung cancer is the most common cause of death from cancer both worldwide and in the United States. There has been a remarkable progress in the treatment of lung cancer with an increasing number of highly effective targeted therapies and the incorporation of immune checkpoint inhibitors into the standard therapy of non‐small‐cell lung cancer, initially in patients with metastatic disease and more recently in earlier stages. These therapeutic advances in combination with reduced incidence of lung cancer associated with the decreased tobacco smoking have led to a sharp decrease in lung cancer mortality over the past few years.

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CT Screening for Lung Cancer: Part-Solid Nodules in Baseline and Annual Repeat Rounds

Abstract: Lung cancers manifesting as part-solid nodules at repeat screening studies all started as nonsolid nodules. Among 107 cases of adenocarcinoma manifesting as a part-solid nodule, a single lymph node metastasis was found in a single case (solid component, 12 mm).

Cited by 101 publications

References 30 publications

The importance of the regimen of screening in maximizing the benefit and minimizing the harms

The importance of the regimen of screening in maximizing the benefit and minimizing the harms

Screening for Lung Cancer With Low-Dose Computed Tomography

Cancer of the Lung

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