Lung-Reporting and Data System 2.0: Impact of the Updated Approach to Juxtapleural Nodules During Lung Cancer Screening Using the National Lung Cancer Screening Trial Data Set.

IF 2 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Thoracic Imaging Pub Date : 2024-07-01 Epub Date: 2023-10-23 DOI:10.1097/RTI.0000000000000756
Lydia Chelala, Rydhwana Hossain, Jean Jeudy, Ziad Nader, Julia Kastner, Charles White
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Abstract

Purpose: To determine the frequency of malignancy of nonperifissural juxtapleural nodules (JPNs) measuring 6 to < 10 mm in a subset of low-dose chest computed tomographies from the National Lung Cancer Screening Trial and the rate of down-classification of such nodules in Lung-Reporting and Data System (RADS) 2.0 compared with Lung-RADS 1.1.

Materials and methods: A secondary analysis of a subset of the National Lung Screening Trial was performed. An exemption was granted by the Institutional Review Board. The dominant noncalcified nodule measuring 6 to <10 mm was identified on all available prevalence computed tomographies. Nodules were categorized as pleural or nonpleural. Benign or malignant morphology was recorded. Initial and updated categories based on Lung-RADS 1.1 and Lung-RADS 2.0 were assigned, respectively. The impact of the down-classification of JPN was assessed. Both classification schemes were compared using the McNemar test ( P < 0.01).

Results: A total of 2813 patients (62 ± 5 y, 1717 men) with 4408 noncalcified nodules were studied. One thousand seventy-three dominant nodules measuring 6 to <10 mm were identified. Three hundred forty-eight (32.4%) were JPN. The updated scheme allowed down-classification of 310 JPN from categories 3 (n = 198) and 4A (n = 112) to category 2. We, therefore, estimate a 4.8% rate of down-classification to category 2 in the entire National Lung Screening Trial screening group. Two/348 (0.57%) JPN were malignant, both nonbenign in morphology. The false-positive rate decreased in the updated classification ( P < 0.01).

Conclusion: This study demonstrates the low malignant potential of benign morphology JPN measuring 6 mm to <10 mm. The Lung-RADS 2.0 approach to JPN is estimated to reduce short-term follow-ups and false-positive results.

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肺报告和数据系统2.0:使用国家癌症筛查试验数据集对癌症筛查期间神经旁结节更新方法的影响。
目的:确定6至<10的非穿透性神经旁结节(JPNs)的恶性频率 mm,以及肺报告和数据系统(RADS)2.0与肺RADS 1.1相比的此类结节的下分类率。材料和方法:对国家肺筛查试验的一个子集进行二次分析。机构审查委员会批准了一项豁免。优势非钙化结节测量6至结果:共有2813名患者(62±5 y、 1717名男性)与4408个非钙化结节进行了研究。一百七十三个优势结节的测量值为6。结论:本研究证明良性形态JPN的恶性潜能较低,测量值为6mm
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来源期刊
Journal of Thoracic Imaging
Journal of Thoracic Imaging 医学-核医学
CiteScore
7.10
自引率
9.10%
发文量
87
审稿时长
6-12 weeks
期刊介绍: Journal of Thoracic Imaging (JTI) provides authoritative information on all aspects of the use of imaging techniques in the diagnosis of cardiac and pulmonary diseases. Original articles and analytical reviews published in this timely journal provide the very latest thinking of leading experts concerning the use of chest radiography, computed tomography, magnetic resonance imaging, positron emission tomography, ultrasound, and all other promising imaging techniques in cardiopulmonary radiology. Official Journal of the Society of Thoracic Radiology: Japanese Society of Thoracic Radiology Korean Society of Thoracic Radiology European Society of Thoracic Imaging.
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