Skip to main content

Advertisement

Log in

Long-term follow-up of non-calcified pulmonary nodules (<10 mm) identified during low-dose CT screening for lung cancer

  • Chest
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To assess the long-term stability of small (<10 mm) non-calcified pulmonary nodules (NCNs) in high-risk subjects initially screened for lung cancer using low-dose chest computed tomography (LDCCT).

Methods

A total of 449 subjects initially underwent screening with serial LDCCT over a 2-year period. Participants identified as having NCNs ≥10 mm were referred for formal lung cancer workup. NCNs <10 mm diameter were followed in accordance with the study protocol. Seven years after baseline screening, subjects with previously documented NCNs <10 mm, which were unchanged in size after the 2-year follow-up period, were re-imaged using LDCCT to assess for interval nodule growth.

Results

Eighty-three subjects with previously documented stable NCNs <10 mm underwent LDCCT at 7 years. NCNs were unchanged in 78 subjects and had decreased in size in 4 subjects. There was interval growth of an NCN (from 6 mm to 9 mm) in one subject re-imaged at 7 years, but this nodule has remained stable in size over a further 2-year follow-up period.

Conclusions

Non-calcified pulmonary nodules <10 mm in size that are unchanged in size or smaller after 2 years of follow-up with LDCCT are most likely benign.

Key Points

• Computed tomography is increasingly used for screening for lung cancer.

• However CT frequently reveals unsuspected lung nodules.

• Seven-year follow-up of small (<10 mm) non-calcified pulmonary nodules is reassuring.

• Even in high-risk patients most nodules will likely be benign.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Shibuya K, Mathers CD, Boschi-Pinto C, Lopez AD, Murray CJ (2002) Global and regional estimates of cancer mortality and incidence by site: II. Results for the global burden of disease 2000. BMC Cancer 2:37

    Article  PubMed  Google Scholar 

  2. Henschke CI, McCauley DI, Yankelevitz DF et al (1999) Early Lung Cancer Action Project: overall design and findings from baseline screening. Lancet 354:99–105

    Article  PubMed  CAS  Google Scholar 

  3. Byrne AL, Logan PM (2006) Screening for lung cancer. Radiol Updat 5:85–91

    Google Scholar 

  4. Sobue T, Moriyama N, Kaneko M et al (2002) Screening for lung cancer with low-dose helical computed tomography: anti-lung cancer association project. J Clin Oncol 20:911–920

    Article  PubMed  Google Scholar 

  5. Henschke CI, Naidich DP, Yankelevitz DF et al (2001) Early lung cancer action project: initial findings on repeat screenings. Cancer 92:153–159

    Article  PubMed  CAS  Google Scholar 

  6. Noguchi M, Morikawa A, Kawasaki M et al (1995) Small adenocarcinoma of the lung. Histologic characteristics and prognosis. Cancer 75:2844–2852

    Article  PubMed  CAS  Google Scholar 

  7. Aberle DR, Adams AM, Berg CD et al (2011) Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 365:395–409

    Article  PubMed  Google Scholar 

  8. Macredmond R, Logan PM, Lee MJ, Kenny D, Foley C, Costello RW (2004) Screening for lung cancer using low dose CT scanning. Thorax 59:237–241

    Article  PubMed  CAS  Google Scholar 

  9. Macredmond R, McVey G, Lee MJ et al (2006) Screening for lung cancer using low dose CT scanning: results of 2 year follow up. Thorax 61:54–56

    Article  PubMed  CAS  Google Scholar 

  10. Wahidi MM, Govert JA, Goudar RK, Gould MK, McCrory DC (2007) Evidence for the treatment of patients with pulmonary nodules: when is it lung cancer?: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 132:94S–107S

    Article  PubMed  Google Scholar 

  11. Edey AJ, Hansell DM (2009) Incidentally detected small pulmonary nodules on CT. Clin Radiol 64:872–884

    Article  PubMed  CAS  Google Scholar 

  12. MacMahon H, Austin JH, Gamsu G et al (2005) Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society. Radiology 237:395–400

    Article  PubMed  Google Scholar 

  13. Khan A (2007) ACR Appropriateness Criteria on solitary pulmonary nodule. J Am Coll Radiol 4:152–155

    Article  PubMed  Google Scholar 

  14. Gould MK, Fletcher J, Iannettoni MD et al (2007) Evaluation of patients with pulmonary nodules: when is it lung cancer?: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 132:108S–130S

    Article  PubMed  Google Scholar 

  15. Good CA, Wilson TW (1958) The solitary circumscribed pulmonary nodule; study of seven hundred five cases encountered roentgenologically in a period of three and one-half years. J Am Med Assoc 166:210–215

    Article  PubMed  CAS  Google Scholar 

  16. Good CA (1953) Management of patient with solitary mass in lung. Chic Med Soc Bull 55:893–896

    Google Scholar 

  17. Good CA, Hood RT Jr, Mc DJ (1953) Significance of a solitary mass in the lung. Am J Roentgenol Radium Ther Nucl Med 70:543–554

    PubMed  CAS  Google Scholar 

  18. Hood RT Jr, Good CA, Clagett OT, McDonald JR (1953) Solitary circumscribed lesions of the lung; study of 156 cases in which resection was performed. J Am Med Assoc 152:1185–1191

    Article  PubMed  Google Scholar 

  19. Yankelevitz DF, Henschke CI (1997) Does 2-year stability imply that pulmonary nodules are benign? AJR Am J Roentgenol 168:325–328

    PubMed  CAS  Google Scholar 

  20. Lillington GA (1991) Management of solitary pulmonary nodules. Dis Mon 37:271–318

    Article  PubMed  CAS  Google Scholar 

  21. Winer-Muram HT, Jennings SG, Tarver RD et al (2002) Volumetric growth rate of stage I lung cancer prior to treatment: serial CT scanning. Radiology 223:798–805

    Article  PubMed  Google Scholar 

  22. Revel MP, Merlin A, Peyrard S et al (2006) Software volumetric evaluation of doubling times for differentiating benign versus malignant pulmonary nodules. AJR Am J Roentgenol 187:135–142

    Article  PubMed  Google Scholar 

  23. Yankelevitz DF, Reeves AP, Kostis WJ, Zhao B, Henschke CI (2000) Small pulmonary nodules: volumetrically determined growth rates based on CT evaluation. Radiology 217:251–256

    PubMed  CAS  Google Scholar 

  24. Quint LE, Cheng J, Schipper M, Chang AC, Kalemkerian G (2008) Lung lesion doubling times: values and variability based on method of volume determination. Clin Radiol 63:41–48

    Article  PubMed  Google Scholar 

  25. Hasegawa M, Sone S, Takashima S et al (2000) Growth rate of small lung cancers detected on mass CT screening. Br J Radiol 73:1252–1259

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael J. Lee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Slattery, M.M., Foley, C., Kenny, D. et al. Long-term follow-up of non-calcified pulmonary nodules (<10 mm) identified during low-dose CT screening for lung cancer. Eur Radiol 22, 1923–1928 (2012). https://doi.org/10.1007/s00330-012-2443-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-012-2443-0

Keywords

Navigation