Recent Trends in the Identification of Incidental Pulmonary Nodules

Abstract

Incidental pulmonary nodules are an increasingly common consequence of routine medical care, with an incidence that is much greater than recognized previously. More frequent nodule identification has not been accompanied by increases in the diagnosis of cancerous nodules.

Tumor-Associated Autoantibodies: Re-Optimization of EarlyCDT-Lung Diagnostic Performance and Its Application to Indeterminate Pulmonary Nodules

“…In the United States, there is a well-documented high rate of lung cancer and pulmonary nodules [1] [2]. In recent years, widespread use of computed tomography (CT) resulting from the finding by the National Lung Screening Trial that annual CT screening reduces lung cancer mortality by 20% compared to chest x-ray [3] has resulted in over 50% of CT-screened patients having at least one non-calcified nodule and over 96% of nodules over 4mm being benign (false positive) [3] [4].…”

“…In recent years, widespread use of computed tomography (CT) resulting from the finding by the National Lung Screening Trial that annual CT screening reduces lung cancer mortality by 20% compared to chest x-ray [3] has resulted in over 50% of CT-screened patients having at least one non-calcified nodule and over 96% of nodules over 4mm being benign (false positive) [3] [4]. There is also a high false positive rate and morbidity associated with biopsy or resection of these benign nodules [2] [3] [5]. Consequently, a CT screening program will need substantial resources to perform follow up for every pulmonary nodule detected.…”

Adenocarcinoma in pure ground glass nodules: histological evidence of invasion and open debate on optimal management

“…The attempt to reduce subjective variability in the definition of such qualitative features is being endorsed by software developers because subtle morphological differences in pGGN can play a significant role in prognostication, and it is particularly relevant when assessing the nodule on a single (18) and other types of nodule (19). The importance of risk stratification of pGGN follows the progressive increase in detection of nodules by CT (20). Management of pGGN is particularly debated between resection or active surveillance (21,22).…”

While size matters—advanced “Radiomics” remain promising for the clinical management of ground glass opacities

“…The increasing utilization of diagnostic high-resolution chest CT (HRCT) scans in clinical practice and the implementation of low-dose HRCT lung cancer screening are resulting in the identification of a growing number of incidentally and screen-detected pure ground-glass nodules (pGGN) (1)(2)(3). Consequently, the notoriously difficult clinical management of persistent (defined present for ≥3 months) sub-solid pulmonary nodules including pGGN, represents an increasingly recognized conundrum.…”