Lung cancer screening with low-dose CT: definition of positive, indeterminate, and negative screen results. A nodule management recommendation from the European Society of Thoracic Imaging.
Authors
Affiliations (17)
Affiliations (17)
- Department of Radiology, Antwerp University Hospital, Edegem, Belgium. [email protected].
- Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium. [email protected].
- Scienze Radiologiche, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy.
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany.
- Translational Lung Research Center Heidelberg (TLRC), Member of the German Lung Research Center (DZL), Heidelberg, Germany.
- Faculty of Medicine, University of Latvia, Riga, Latvia.
- Faculty of Medicine, Christian-Albrechts-Universität zu Kiel, Kiel, Germany.
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Department of Oncology, University of Oxford, Oxford, UK.
- Department of Medical Imaging, Radboud University Center, Nijmegen, The Netherlands.
- Department of Radiology, Haraldsplass Deaconess Hospital, Bergen, Norway.
- Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
- Department of Radiology, Meander Medical Center, Amersfoort, The Netherlands.
- Department of Medical Imaging, Radboud University Center, Nijmegen, The Netherlands. [email protected].
- Department of Radiology, University Medical Center Groningen, Groningen, The Netherlands. [email protected].
- Department of Radiology, Cochin Hospital, Université Paris Cité, Paris, France.
Abstract
Early detection of lung cancer through low-dose CT lung cancer screening in a high-risk population has proven to reduce lung cancer-specific mortality. Nodule management plays a pivotal role in early detection and further diagnostic approaches. The European Society of Thoracic Imaging (ESTI) has established a nodule management recommendation to improve the handling of pulmonary nodules detected during screening. For solid nodules, the primary method for assessing the likelihood of malignancy is to monitor nodule growth using volumetry software. For subsolid nodules, the aggressiveness is determined by measuring the solid part. The ESTI-recommendation enhances existing protocols but puts a stronger focus on lesion aggressiveness. The main goals are to minimise the overall number of follow-up examinations while preventing the risk of a major stage shift and reducing the risk of overtreatment. KEY POINTS: Question Assessment of nodule growth and management according to guidelines is essential in lung cancer screening. Findings Assessment of nodule aggressiveness defines follow-up in lung cancer screening. Clinical relevance The ESTI nodule management recommendation aims to reduce follow-up examinations while preventing major stage shift and overtreatment.