open access

Vol 16, No 2 (2020)
Research paper
Published online: 2019-11-19
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Retrospective assessment of Lung-RADS® performance in the Silesian Lung Cancer Screening Pilot Study

Ewa Wachuła, Sylwia Szabłowska-Siwik, Damian Czyżewski, Jerzy Kozielski, Wojciech Rogowski, Mariusz Adamek
DOI: 10.5603/OCP.2019.0034
·
Oncol Clin Pract 2020;16(2):52-55.

open access

Vol 16, No 2 (2020)
ORIGINAL ARTICLE
Published online: 2019-11-19

Abstract

Background. A high percentage of false positive results, observed in lung cancer screening studies with low-dose computed tomography (LDCT), caused the modification of radiological assessment methods. According to the International Early Lung Cancer Action Program (IELCAP) all non-calcified nodules with a dimension ≥ 4 mm were considered as positive. Implementation of classification the Lung CT screening Reporting and Data System (Lung-RADS®) recommends additional testing only for nodules ≥ 6 mm, which reduced of false positive results.

Methods. We provided a retrospective analysis of 601 LDCT scans, in asymptomatic volunteers of Pilot Silesian Study of Early Lung Cancer Detection, with at least 20 pack-years of cigarette smoking. The analysis of non- and invasive interventions was done. Assessment of nodules according to the Lung-RADS® system was done. Then the percentage of interventions that could be avoided using the Lung-RADS® criteria was estimated.

Results. In total, 1016 nodules were identified in 265 participants. The positive result of screening was defined as a presence of solid or part-solid nodule ≥ 5 mm and ≥ 8 mm in the case of a nonsolid nodule in line with the IELCAP protocol. Screening based on the IELCAP protocol resulted in 200 positive results and based on Lung-RADS® in the 116 positives. The frequency of lung cancers among participants with a positive result was 7 of 200 (4.0%) (95% CI: 1.0%, 6.0%) for IELCAP and 7 of 116 (6.0%) (95% CI: 2.7%, 9.3%) for Lung-RADS®. The Lung-RADS® criteria reduced number of non- and invasive procedures by 48.8% and 24.1%, compared to IELCAP protocol.

Conclusions. Adopting the Lung-RADS® classification system may reduce harms and improve the efficiency of lung cancer screening programs.

Abstract

Background. A high percentage of false positive results, observed in lung cancer screening studies with low-dose computed tomography (LDCT), caused the modification of radiological assessment methods. According to the International Early Lung Cancer Action Program (IELCAP) all non-calcified nodules with a dimension ≥ 4 mm were considered as positive. Implementation of classification the Lung CT screening Reporting and Data System (Lung-RADS®) recommends additional testing only for nodules ≥ 6 mm, which reduced of false positive results.

Methods. We provided a retrospective analysis of 601 LDCT scans, in asymptomatic volunteers of Pilot Silesian Study of Early Lung Cancer Detection, with at least 20 pack-years of cigarette smoking. The analysis of non- and invasive interventions was done. Assessment of nodules according to the Lung-RADS® system was done. Then the percentage of interventions that could be avoided using the Lung-RADS® criteria was estimated.

Results. In total, 1016 nodules were identified in 265 participants. The positive result of screening was defined as a presence of solid or part-solid nodule ≥ 5 mm and ≥ 8 mm in the case of a nonsolid nodule in line with the IELCAP protocol. Screening based on the IELCAP protocol resulted in 200 positive results and based on Lung-RADS® in the 116 positives. The frequency of lung cancers among participants with a positive result was 7 of 200 (4.0%) (95% CI: 1.0%, 6.0%) for IELCAP and 7 of 116 (6.0%) (95% CI: 2.7%, 9.3%) for Lung-RADS®. The Lung-RADS® criteria reduced number of non- and invasive procedures by 48.8% and 24.1%, compared to IELCAP protocol.

Conclusions. Adopting the Lung-RADS® classification system may reduce harms and improve the efficiency of lung cancer screening programs.

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Keywords

lung nodules; lung cancer screening; low dose computed tomography (LDCT); Lung CT Screening Reporting and Data System (Lung-RADS®)

About this article
Title

Retrospective assessment of Lung-RADS® performance in the Silesian Lung Cancer Screening Pilot Study

Journal

Oncology in Clinical Practice

Issue

Vol 16, No 2 (2020)

Article type

Research paper

Pages

52-55

Published online

2019-11-19

DOI

10.5603/OCP.2019.0034

Bibliographic record

Oncol Clin Pract 2020;16(2):52-55.

Keywords

lung nodules
lung cancer screening
low dose computed tomography (LDCT)
Lung CT Screening Reporting and Data System (Lung-RADS®)

Authors

Ewa Wachuła
Sylwia Szabłowska-Siwik
Damian Czyżewski
Jerzy Kozielski
Wojciech Rogowski
Mariusz Adamek

References (11)
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