Imaging Of Lung Disease, Part II: ­Cavities, Cysts, Nodules, And Masses

2018 ◽  
Author(s):  
Gerald W. Staton Jr ◽  
Eugene A Berkowitz ◽  
Adam Bernheim
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Lung Disease ◽  
Interstitial Pneumonia ◽  
Pulmonary Nodules ◽  
Lung Cancer Screening ◽  
Cystic Lung ◽  
Cystic Lung Disease ◽  
Clinical Scenarios

Cavitary lesions may occur in the setting of pulmonary infection, neoplasm, or vasculitis.  Cystic lung disease must be differentiated from emphysema and is seen in lymphangioleiomyomatosis, Langerhans cell histiocytosis (LCH), and lymphoid interstitial pneumonia (LIP).  Pulmonary nodules are routinely encountered on chest imaging and may be due to benign or malignant etiologies.  There are follow-up algorithms that provide recommendations for solid and sub-solid nodules in certain clinical scenarios.  Nodules characteristics (such as size, morphology, and number [solitary versus multiple]) and patient characteristics (including age, oncology history, and cigarette smoking status) are important to consider in formulating a differential diagnosis and follow-up plan.  Lung cancer screening computed tomography (CT) is now a recommended screening test for high-risk patients who meet certain eligibility requirements, and should be reported according to the Lung Imaging Reporting and Data System (Lung-RADS). This review contains 28 figures, 3 tables and 26 references Keywords: Cavitary Lung Disease, Granulomatosis with Polyangiitis, Cystic Lung Disease, Lymphoid Interstitial Pneumonia, Pulmonary Emphysema, Pulmonary Nodules, Pulmonary Granulomatous Disease, Arteriovenous Malformation, Lung Cancer Screening, Pulmonary Fungal Infection

scholarly journals Optimizing the timing of diagnostic testing after positive findings in lung cancer screening: a proof of concept radiomics study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Zixing Wang ◽  
Ning Li ◽  
Fuling Zheng ◽  
Xin Sui ◽  
Wei Han ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Cancer Diagnosis ◽  
Diagnostic Testing ◽  
Delayed Diagnosis ◽  
Pulmonary Nodules ◽  
Lung Cancer Screening ◽  
Lung Cancer Diagnosis ◽  
Risk Patients

Abstract Background The timeliness of diagnostic testing after positive screening remains suboptimal because of limited evidence and methodology, leading to delayed diagnosis of lung cancer and over-examination. We propose a radiomics approach to assist with planning of the diagnostic testing interval in lung cancer screening. Methods From an institute-based lung cancer screening cohort, we retrospectively selected 92 patients with pulmonary nodules with diameters ≥ 3 mm at baseline (61 confirmed as lung cancer by histopathology; 31 confirmed cancer-free). Four groups of region-of-interest-based radiomic features (n = 310) were extracted for quantitative characterization of the nodules, and eight features were proven to be predictive of cancer diagnosis, noise-robust, phenotype-related, and non-redundant. A radiomics biomarker was then built with the random survival forest method. The patients with nodules were divided into low-, middle- and high-risk subgroups by two biomarker cutoffs that optimized time-dependent sensitivity and specificity for decisions about diagnostic workup within 3 months and about repeat screening after 12 months, respectively. A radiomics-based follow-up schedule was then proposed. Its performance was visually assessed with a time-to-diagnosis plot and benchmarked against lung RADS and four other guideline protocols. Results The radiomics biomarker had a high time-dependent area under the curve value (95% CI) for predicting lung cancer diagnosis within 12 months; training: 0.928 (0.844, 0.972), test: 0.888 (0.766, 0.975); the performance was robust in extensive cross-validations. The time-to-diagnosis distributions differed significantly between the three patient subgroups, p < 0.001: 96.2% of high-risk patients (n = 26) were diagnosed within 10 months after baseline screen, whereas 95.8% of low-risk patients (n = 24) remained cancer-free by the end of the study. Compared with the five existing protocols, the proposed follow-up schedule performed best at securing timely lung cancer diagnosis (delayed diagnosis rate: < 5%) and at sparing patients with cancer-free nodules from unnecessary repeat screenings and examinations (false recommendation rate: 0%). Conclusions Timely management of screening-detected pulmonary nodules can be substantially improved with a radiomics approach. This proof-of-concept study’s results should be further validated in large programs.

scholarly journals Lung Screen Uptake Trial: results from a single lung cancer screening round

Thorax ◽  
2020 ◽  
Vol 75 (10) ◽  
pp. 908-912
Author(s):  
Mamta Ruparel ◽  
Samantha L Quaife ◽  
Jennifer L Dickson ◽  
Carolyn Horst ◽  
Sophie Tisi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Low Dose ◽  
Pulmonary Nodules ◽  
Lung Cancer Screening ◽  
Small Cell Lung ◽  
Curative Intent ◽  
Lung Cancers ◽  
Lung Health

The Lung Screen Uptake Trial tested a novel invitation strategy to improve uptake and reduce socioeconomic and smoking-related inequalities in lung cancer screening (LCS) participation. It provides one of the first UK-based ‘real-world’ LCS cohorts. Of 2012 invited, 1058 (52.6%) attended a ‘lung health check’. 768/996 (77.1%) in the present analysis underwent a low-dose CT scan. 92 (11.9%) and 33 (4.3%) participants had indeterminate pulmonary nodules requiring 3-month and 12-month surveillance, respectively; 36 lung cancers (4.7%) were diagnosed (median follow-up: 1044 days). 72.2% of lung cancers were stage I/II and 79.4% of non-small cell lung cancer had curative-intent treatment.

scholarly journals Effect of Nodule Characteristics on Variability of Semiautomated Volume Measurements in Pulmonary Nodules Detected in a Lung Cancer Screening Program

Radiology ◽  
2008 ◽  
Vol 248 (2) ◽  
pp. 625-631 ◽  
Author(s):  
Ying Wang ◽  
Rob J. van Klaveren ◽  
Hester J. van der Zaag–Loonen ◽  
Geertruida H. de Bock ◽  
Hester A. Gietema ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Screening Program ◽  
Pulmonary Nodules ◽  
Lung Cancer Screening ◽  
Cancer Screening Program ◽  
Volume Measurements ◽  
Lung Cancer Screening Program

scholarly journals Morphological characteristics of potentially malignant pulmonary nodules in high-risk male smokers detected in lung cancer screening trial in Cracow, Poland

2013 ◽  
Vol 2 ◽  
pp. 114-120 ◽  
Author(s):  
Kinga Kiszka ◽  
Lucyna Rudnicka-Sosin ◽  
Romana Tomaszewska ◽  
Małgorzata Urbańczyk-Zawadzka ◽  
Maciej Krupiński ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Morphological Characteristics ◽  
Pulmonary Nodules ◽  
Lung Cancer Screening ◽  
Cancer Screening Trial ◽  
Potentially Malignant ◽  
Screening Trial

scholarly journals Mobile Low-Dose Computed Tomographic (LDCT) Scanning combined with Remote Reading: a feasible approach to lung cancer screening among rural population

2021 ◽  
Author(s):  
Bojiang Chen ◽  
Jun Shao ◽  
Jinghong Xian ◽  
Pengwei Ren ◽  
Wenxin Luo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Rural Areas ◽  
Pulmonary Nodules ◽  
Lung Cancer Screening ◽  
Western China ◽  
Control Group ◽  
Local Hospital ◽  
Lung Cancers ◽  
Computed Tomographic

Abstract BackgroundLow-dose computed tomographic (LDCT) screening has been proven to be powerful in detecting lung cancers in early stage. However, it’s hard to carry out in less-developed regions in lacking of facilities and professionals. The feasibility and efficacy of mobile LDCT scanning combined with remote reading by experienced radiologists from superior hospital for lung cancer screening in deprived areas was explored in this study.MethodsA prospective cohort was conducted in rural areas of western China. Residents over 40 years old were invited for lung cancer screening by mobile LDCT scanning combined with remote image reading or local hospital-based LDCT screening. Rates of positive pulmonary nodules and detected lung cancers in the baseline were compared between the two groups.ResultsAmong 8073 candidates with preliminary response, 7251 eligibilities were assigned to the mobile LDCT with remote reading (n = 4527) and local hospital-based LDCT screening (n = 2724) for lung cancer. Basic characteristics of the subjects were almost similar in the two cohorts except that the mean age of participants in mobile group was relatively older than control (61.18 vs. 59.84 years old, P < 0.001). 1778 participants with mobile LDCT scans with remote reading (39.3%) revealed 2570 pulmonary nodules or mass, and 352 subjects in the control group (13.0%) were detected 472 ones (P < 0.001). Proportions of nodules less than 8 mm or subsolid were both more frequent in the mobile LDCT group (83.3% vs. 76.1%, 32.9% vs. 29.8%, respectively; both P < 0.05). In the baseline screening, 26 cases of lung cancer were identified in the mobile LDCT scanning with remote reading cohort, with a lung cancer detection rate of 0.57% (26/4527), which was significantly higher than control (4/2724 = 0.15%, P = 0.006). Moreover, 80.8% (21/26) of lung cancer patients detected by mobile CT with remote reading were in stage I, remarkedly higher than that of 25.0% in control (1/4, P = 0.020).ConclusionMobile LDCT combined with remote reading is probably a potential mode for lung cancer screening in rural areas.Trial registrationNo. of registration trial was ChiCTR-DDD-15007586 (http://www.chictr.org).

scholarly journals Increased Respiratory Morbidity in Individuals with Interstitial Lung Abnormalities

2020 ◽  
Author(s):  
Nils Hoyer ◽  
Laura H. Thomsen ◽  
Mathilde M.W. Wille ◽  
Torgny Wilcke ◽  
Asger Dirksen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Respiratory Failure ◽  
Cancer Screening ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Respiratory Diseases ◽  
Lung Cancer Screening ◽  
Healthcare Utilisation ◽  
Lung Abnormalities ◽  
Disease Specific

Abstract Background Interstitial lung abnormalities (ILA) are common in participants of lung cancer screening trials and broad population-based cohorts. They are associated with increased mortality, but less is known about disease specific morbidity and healthcare utilisation in individuals with ILA. Methods We included all participants from the screening arm of the Danish Lung Cancer Screening Trial with available baseline CT scan data (n=1990) in this cohort study. The baseline scan was scored for the presence of ILA and patients were followed for up to 12 years. Data about all hospital admissions, primary healthcare visits and medicine prescriptions were collected from the Danish National Health Registries and used to determine the participants’ disease specific morbidity and healthcare utilisation using Cox proportional hazards models. Results The 332 (16.7%) participants with ILA were more likely to be diagnosed with one of several respiratory diseases, including interstitial lung disease (HR: 4.9, 95% CI: 1.8–13.3, p=0.008), COPD (HR: 1.7, 95% CI: 1.2–2.3, p = 0.01), pneumonia (HR: 2.0, 95% CI: 1.4–2.7, p<0.001), lung cancer (HR: 2.7, 95% CI: 1.8–4.0, p<0.001) and respiratory failure (HR: 1.8, 95% CI: 1.1–3.0, p=0.03) compared with participants without ILA. These findings were confirmed by increased hospital admission rates with these diagnoses and more frequent prescriptions for inhalation medicine and antibiotics in participants with ILA. Conclusions Individuals with ILA are more likely to receive a diagnosis and treatment for several respiratory diseases, including interstitial lung disease, COPD, pneumonia, lung cancer and respiratory failure during long-term follow-up.

Prognostic selection and long-term survival analysis to assess overdiagnosis risk in lung cancer screening randomized trials

2020 ◽  
pp. 096914132092303
Author(s):  
Eugenio Paci ◽  
Donella Puliti ◽  
Francesca Maria Carozzi ◽  
Laura Carrozzi ◽  
Fabio Falaschi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Survival Rates ◽  
Lung Cancer Screening ◽  
Term Survival ◽  
Long Term Survival ◽  
And Control ◽  
Screening Trial

Objectives Overdiagnosis in low-dose computed tomography randomized screening trials varies from 0 to 67%. The National Lung Screening Trial (extended follow-up) and ITALUNG (Italian Lung Cancer Screening Trial) have reported cumulative incidence estimates at long-term follow-up showing low or no overdiagnosis. The Danish Lung Cancer Screening Trial attributed the high overdiagnosis estimate to a likely selection for risk of the active arm. Here, we applied a method already used in benefit and overdiagnosis assessments to compute the long-term survival rates in the ITALUNG arms in order to confirm incidence-excess method assessment. Methods Subjects in the active arm were invited for four screening rounds, while controls were in usual care. Follow-up was extended to 11.3 years. Kaplan-Meyer 5- and 10-year survivals of “resected and early” (stage I or II and resected) and “unresected or late” (stage III or IV or not resected or unclassified) lung cancer cases were compared between arms. Results The updated ITALUNG control arm cumulative incidence rate was lower than in the active arm, but this was not statistically significant (RR: 0.89; 95% CI: 0.67–1.18). A compensatory drop of late cases was observed after baseline screening. The proportion of “resected and early” cases was 38% and 19%, in the active and control arms, respectively. The 10-year survival rates were 64% and 60% in the active and control arms, respectively ( p = 0.689). The five-year survival rates for “unresected or late” cases were 10% and 7% in the active and control arms, respectively ( p = 0.679). Conclusions This long-term survival analysis, by prognostic categories, concluded against the long-term risk of overdiagnosis and contributed to revealing how screening works.

Prevalence of incidental interstitial lung disease in the Manchester lung cancer screening pilot

Lung Cancer ◽  
2019 ◽  
Vol 127 ◽  
pp. S23-S24
Author(s):  
H. Balata ◽  
C. Hayton ◽  
P.V. Barber ◽  
R. Duerden ◽  
M. Evison ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Lung Cancer Screening
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