Growing small solid nodules in lung cancer screening : safety and efficacy of a 200 mm3 minimum size threshold for multidisciplinary team referral
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
The optimal management of small but growing nodules remains unclear. The SUMMIT study nodule management algorithm uses a specific threshold volume of 200 mm3 before referral of growing solid nodules to the multidisciplinary team for further investigation is advised, with growing nodules below this threshold kept under observation within the screening programme. Malignancy risk of growing solid nodules of size >200 mm3 at initial 3-month interval scan was 58.3% at a per-nodule level, compared with 13.3% in growing nodules of size ≤200 mm3 (relative risk 4.4, 95% CI 2.17 to 8.83). The positive predictive value of a combination of nodule growth (defined as percentage volume change of ≥25%), and size >200 mm3 was 65.9% (29/44) at a cancer-per-nodule basis, or 60.5% (23/38) on a cancer-per-participant basis. False negative rate of the protocol was 1.9% (95% CI 0.33% to 9.94%). These findings support the use of a 200 mm3 minimum volume threshold for referral as effective at reducing unnecessary multidisciplinary team referrals for small growing nodules, while maintaining early-stage lung cancer diagnosis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:78 |
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| Enthalten in: |
Thorax - 78(2023), 2 vom: 18. Feb., Seite 202-206 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Creamer, Andrew W [VerfasserIn] |
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| Links: |
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| Themen: |
Imaging/CT MRI etc |
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| Anmerkungen: |
Date Completed 16.01.2023 Date Revised 10.02.2024 published: Print-Electronic ClinicalTrials.gov: NCT03934866 Citation Status MEDLINE |
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| doi: |
10.1136/thorax-2022-219403 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a The optimal management of small but growing nodules remains unclear. The SUMMIT study nodule management algorithm uses a specific threshold volume of 200 mm3 before referral of growing solid nodules to the multidisciplinary team for further investigation is advised, with growing nodules below this threshold kept under observation within the screening programme. Malignancy risk of growing solid nodules of size >200 mm3 at initial 3-month interval scan was 58.3% at a per-nodule level, compared with 13.3% in growing nodules of size ≤200 mm3 (relative risk 4.4, 95% CI 2.17 to 8.83). The positive predictive value of a combination of nodule growth (defined as percentage volume change of ≥25%), and size >200 mm3 was 65.9% (29/44) at a cancer-per-nodule basis, or 60.5% (23/38) on a cancer-per-participant basis. False negative rate of the protocol was 1.9% (95% CI 0.33% to 9.94%). These findings support the use of a 200 mm3 minimum volume threshold for referral as effective at reducing unnecessary multidisciplinary team referrals for small growing nodules, while maintaining early-stage lung cancer diagnosis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a imaging/CT MRI etc | |
| 650 | 4 | |a lung cancer | |
| 700 | 1 | |a Horst, Carolyn |e verfasserin |4 aut | |
| 700 | 1 | |a Dickson, Jennifer L |e verfasserin |4 aut | |
| 700 | 1 | |a Tisi, Sophie |e verfasserin |4 aut | |
| 700 | 1 | |a Hall, Helen |e verfasserin |4 aut | |
| 700 | 1 | |a Verghese, Priyam |e verfasserin |4 aut | |
| 700 | 1 | |a Prendecki, Ruth |e verfasserin |4 aut | |
| 700 | 1 | |a Bhamani, Amyn |e verfasserin |4 aut | |
| 700 | 1 | |a McCabe, John |e verfasserin |4 aut | |
| 700 | 1 | |a Gyertson, Kylie |e verfasserin |4 aut | |
| 700 | 1 | |a Mullin, Anne-Marie |e verfasserin |4 aut | |
| 700 | 1 | |a Teague, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a Farrelly, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Hackshaw, Allan |e verfasserin |4 aut | |
| 700 | 1 | |a Nair, Arjun |e verfasserin |4 aut | |
| 700 | 0 | |a SUMMIT consortium |e verfasserin |4 aut | |
| 700 | 1 | |a Devaraj, Anand |e verfasserin |4 aut | |
| 700 | 1 | |a Janes, Sam M |e verfasserin |4 aut | |
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