OBJECTIVES: To characterize early features of lung cancers detected with low-dose computed tomography (LDCT) screening. MATERIALS AND METHODS: Two radiologists reviewed prior LDCTs in 20 incident cancers diagnosed at annual repeat screening rounds and 83 benign nodules observed in the ITALUNG trial. RESULTS: No abnormality was observed in 3 cancers. Focal abnormalities in prior LDCT were identified in 17(85%) cancers (14 adenocarcinomas; 14 stage I). Initial abnormalities were intra-pulmonary in 10, subpleural in 4 and perifissural in 3. Average mean diameter was 9mm (range 4.5-18mm). Nine exhibited solid, 4 part-solid and 4 non-solid density. The margins were smooth and regular in 5 cases, lobulated in 6, irregular with spiculations in 3 and blurred in 3. Ten (59%) initial focal abnormalities had a round or oval nodular shape, but 7(41%) had a non-nodular complex (n=5) or "stripe-like" (n=2) shape. Bronchus sign was observed in 3 cases and association with cystic airspace in 2 cases. Non-solid density, complex or "stripe-like" shape, bronchus sign and association with cystic airspace had a specificity higher than 90%, but positive predictive value of every feature of incident lung cancers was low (range 10.4-50%). CONCLUSIONS: The vast majority of cancers diagnosed at annual repeat show corresponding focal lung abnormalities in prior LDCTs. Perifissural location and non-nodular shape do not exclude the possibility of early lung cancer. Since specificity of the early features of incident lung cancer is incomplete and their positive predictive value is low, all focal pulmonary abnormalities detected in screened subjects should be re-evaluated in subsequent LDCTs.

Initial LDCT appearance of incident lung cancers in the ITALUNG trial / Mario Mascalchi;Giulia Picozzi;Massimo Falchini;Alessandra Vella;Stefano Diciotti;Laura Carrozzi;Andrea Lopes Pegna;Fabio Falaschi. - In: EUROPEAN JOURNAL OF RADIOLOGY. - ISSN 0720-048X. - STAMPA. - 83:(2014), pp. 2080-2086. [10.1016/j.ejrad.2014.07.019]

Initial LDCT appearance of incident lung cancers in the ITALUNG trial

DICIOTTI, STEFANO;
2014

Abstract

OBJECTIVES: To characterize early features of lung cancers detected with low-dose computed tomography (LDCT) screening. MATERIALS AND METHODS: Two radiologists reviewed prior LDCTs in 20 incident cancers diagnosed at annual repeat screening rounds and 83 benign nodules observed in the ITALUNG trial. RESULTS: No abnormality was observed in 3 cancers. Focal abnormalities in prior LDCT were identified in 17(85%) cancers (14 adenocarcinomas; 14 stage I). Initial abnormalities were intra-pulmonary in 10, subpleural in 4 and perifissural in 3. Average mean diameter was 9mm (range 4.5-18mm). Nine exhibited solid, 4 part-solid and 4 non-solid density. The margins were smooth and regular in 5 cases, lobulated in 6, irregular with spiculations in 3 and blurred in 3. Ten (59%) initial focal abnormalities had a round or oval nodular shape, but 7(41%) had a non-nodular complex (n=5) or "stripe-like" (n=2) shape. Bronchus sign was observed in 3 cases and association with cystic airspace in 2 cases. Non-solid density, complex or "stripe-like" shape, bronchus sign and association with cystic airspace had a specificity higher than 90%, but positive predictive value of every feature of incident lung cancers was low (range 10.4-50%). CONCLUSIONS: The vast majority of cancers diagnosed at annual repeat show corresponding focal lung abnormalities in prior LDCTs. Perifissural location and non-nodular shape do not exclude the possibility of early lung cancer. Since specificity of the early features of incident lung cancer is incomplete and their positive predictive value is low, all focal pulmonary abnormalities detected in screened subjects should be re-evaluated in subsequent LDCTs.
2014
Initial LDCT appearance of incident lung cancers in the ITALUNG trial / Mario Mascalchi;Giulia Picozzi;Massimo Falchini;Alessandra Vella;Stefano Diciotti;Laura Carrozzi;Andrea Lopes Pegna;Fabio Falaschi. - In: EUROPEAN JOURNAL OF RADIOLOGY. - ISSN 0720-048X. - STAMPA. - 83:(2014), pp. 2080-2086. [10.1016/j.ejrad.2014.07.019]
Mario Mascalchi;Giulia Picozzi;Massimo Falchini;Alessandra Vella;Stefano Diciotti;Laura Carrozzi;Andrea Lopes Pegna;Fabio Falaschi
File in questo prodotto:
Eventuali allegati, non sono esposti

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/394744
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? 5
  • Scopus 14
  • ???jsp.display-item.citation.isi??? 14
social impact