Modified Lung-RADS Improves Performance of Screening LDCT in a Population with High Prevalence of Non–smoking-related Lung Cancer
| Autor: | Guang Yuan Mar, Chuan Ling Wu, Chia Hao Liang, Carol C. Wu, Jo Ching Wang, Fu Zong Wu, Ruay Sheng Lai, Chi Shen Chen, Hui Ting Hsu, Yi Luan Huang, Ming Ting Wu, En Kuei Tang |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Lung Neoplasms Population Taiwan Adenocarcinoma Sensitivity and Specificity 030218 nuclear medicine & medical imaging Cohort Studies 03 medical and health sciences 0302 clinical medicine Asian People Prevalence medicine Data Systems Humans Cutoff Radiology Nuclear Medicine and imaging education Lung cancer Early Detection of Cancer Aged Retrospective Studies Aged 80 and over education.field_of_study Receiver operating characteristic business.industry Area under the curve Retrospective cohort study Middle Aged medicine.disease Radiology Information Systems 030220 oncology & carcinogenesis Female National Lung Screening Trial Radiology Tomography X-Ray Computed business |
| Zdroj: | Academic Radiology. 25:1240-1251 |
| ISSN: | 1076-6332 |
| DOI: | 10.1016/j.acra.2018.01.012 |
| Popis: | We proposed a modification of the ACR Lung Imaging Reporting and Data System (Lung-RADS) to clarify the characteristics of subsolid nodules with categories 1-11, and to compare the diagnostic accuracy with Lung-RADS and National Lung Screening Trial criteria in an Asian population with high prevalence of adenocarcinoma.We analyzed a retrospective cohort of 1978 consecutive healthy subjects (72.8% nonsmoker) who underwent low-dose computed tomography from August 2013 to October 2014 (1084 men, 894 women). Lung-RADS categories 2 and 3 were modified to include subcategories of 2A/2B/2C and 3A/3B/3C, respectively. Clinical information and nodule characteristics were recorded. Receiver operating characteristic curves were used to compare diagnostic accuracy at different cutoffs.Thirty-two subjects (30 nonsmokers) had pathology-proven adenocarcinoma spectrum lesions in the follow-up period (1.6 ± 0.5 years). Modified Lung-RADS, using modified Lung-RADS category 2C as cutoff, had an area under the curve (AUC) of 0.973 in predicting adenocarcinoma spectrum lesions (sensitivity of 100%, specificity of 89.3%), which was significantly higher than that of Lung-RADS (AUC = 0.815, P .001) and National Lung Screening Trial (AUC = 0.906, P .001). Furthermore, modified Lung-RADS showed an AUC of 0.992 in predicting invasive adenocarcinoma (sensitivity of 95%, specificity of 97.8%) when category 3B was used as cutoff.Modified Lung-RADS may substantially improve sensitivity while maintaining specificity for detection of adenocarcinoma spectrum lesions in an Asian population. Compared to Lung-RADS, it has enhanced ability to differentiate invasive from indolent adenocarcinoma by more refined subclassification of subsolid nodules using two cutoff values of category 2C and 3B. The effect of using modified Lung-RADS in clinical practice must be carefully studied in prospective large cohort studies. |
| Databáze: | OpenAIRE |
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