Clinical significance of noncalcified lung nodules in patients with breast cancer
|
|
- Berniece Hunt
- 5 years ago
- Views:
Transcription
1 Breast Cancer Res Treat (2016) 159: DOI /s CLINICAL TRIAL Clinical significance of noncalcified lung nodules in patients with breast cancer Feng Li 1 Samuel G. Armato 1 Maryellen L. Giger 1 Heber MacMahon 1 Received: 16 May 2016 / Accepted: 3 August 2016 / Published online: 9 August 2016 Springer Science+Business Media New York 2016 Abstract Patients with breast cancer are increasingly likely to have chest computed tomography (CT) performed. In many cases, small lung nodules will be detected, raising concern for metastases and causing considerable patient anxiety. The majority of these nodules, however, are benign, though the specific probability of malignancy is uncertain in any given case. Therefore, we analyzed the results of chest CT scans of a large number of patients with breast cancer, to determine characteristics and clinical significance of noncalcified lung nodules patients were investigated, and 4889 CT scans from 1325 patients were retrospectively reviewed. Among the 1325 patients, 812 (59 %) had at least one noncalcified lung nodule, of which 330 (41 %) had malignant nodules, 197 (24 %) had large (C10 mm) nodules, and 586 (72 %) had multiple nodules. Large nodules were more often malignant than benign (P \ 0.001). In patients with multiple large nodules, the rate of malignancy rate was 83 %, and most of these were metastases. In the case of very small (2 4 mm) nodules, the malignancy rates for solitary and multiple nodules were 8 and 20 %, respectively. Lung metastases were more likely with breast cancer cell grade 3 (22 %) than grade 1 2 (10 %) (P \ 0.001) and when patients were clinical stage 2 3 (14 %) than stage 0 1 (7.9 %) (P = 0.03). Lung metastases are highly likely in patients with multiple nodules greater than 10 mm. Higher cancer cell grades and clinical stage are also related to an Presented in part at the RSNA 2014 meeting. & Feng Li feng@uchicago.edu 1 Department of Radiology, The University of Chicago, 5841 S. Maryland Avenue, MC 2026, Chicago, IL 60637, USA increased likelihood of lung metastases. The great majority of small lung nodules in breast cancer patients are benign. Keywords Breast cancer Chest CT Lung nodule Malignant or benign Lung metastases Introduction Much progress has been made in cancer prevention, early detection, and treatment, with resulting reduction in mortality rates and improved survival for patients with breast cancer [1]. Chest radiography (CXR) is commonly used in newly diagnosed patients with breast cancer for baseline staging [2 6]. For patients without clinical signs of tumor spread, CXR is not recommended, because the frequency of lung metastases is as low as 0.1 % in clinical stage 1 and 0.2 % in stage 2 compared with 1.7 % in stage 3 disease [3]. Recently, chest computed tomography (CT) has been used increasingly for routine staging of breast cancer patients [6 11], and some patients with breast cancer require chest CT scans for other diagnostic purposes such as lung or cardiac disease. Noncalcified solitary or multiple lung nodules are encountered on many of these scans; however, a large majority of these nodules are benign [7, 8], though the likelihood of such nodules representing metastatic disease is uncertain in individual cases. Therefore, we evaluated the size and number of lung nodules on the chest CT scans of breast cancer patients from 1 year prior to breast cancer diagnosis through treatment and follow-up and correlated these findings with breast cancer cell grade and breast cancer clinical stage to provide a basis for determining the probability of malignancy in individual cases.
2 266 Breast Cancer Res Treat (2016) 159: Patient selection Institutional review board approval was obtained, and the requirement for informed patient consent was waived for this retrospective study, which was compliant with the Health Insurance Portability and Accountability Act (HIPAA). The clinical information of all 3313 patients who had been entered into the University of Chicago Medical Center breast cancer registry between January 2002 and December 2011 was reviewed by an experienced chest radiologist (FL, clinical experience more than 15 years). Among these 3313 patients, 100 patients (7 %) had more than one primary breast lesion (96 patients had two breast cancers and four patients had three breast cancers in one or both breasts); for these patients, only the most recently diagnosed primary breast cancer was used for data analysis. Among these patients, 1941 (59 %) patients had no chest CT scan, and 47 (1.4 %) patients had all their CT scans performed more than 1 year prior to breast cancer diagnosis. The remaining 1325 (40 %) patients had 4889 chest CT scans, of which at least one scan had been performed during the period from more than 1 year prior to the breast cancer diagnosis through July 2013; these were the cases used in the current study. Lung nodule inventory The same radiologist reviewed all CT images along with radiology reports and pathology reports, when available, for the 1325 breast cancer patients with chest CT scans. Among these patients, 522 (39 %) patients had only one CT scan, and 803 (61 %) patients had more than one CT scan. All 4889 chest CT scans from these 1325 patients were reviewed to determine whether the patient had noncalcified lung nodules. Among these patients, the criterion for inclusion in this study was the presence of noncalcified lung nodules visible on a CT scan acquired from 1 year prior to the diagnosis of breast cancer through follow-up; the follow-up time period for this study ended in July Only one CT scan per patient was used for nodule analysis (i.e., the scan on which the noncalcified lung nodules were first visible). All chest CT scans and images from other modalities (e.g., CXR and PET) or pathology information, if available, were used to confirm the final diagnosis of the lung nodules. The malignant lung nodules included pathology-proven lung cancers, nodular metastases with pathological proof or clinical proof (increased nodule number and size or response to cancer treatment by follow-up imaging findings), and suspicious or indeterminate nodules according to imaging findings. The benign lung nodule category included both definitively benign nodules (pathology-proven, resolved at follow-up, solid nodules stable over at least 2 years, and nodules with benign patterns of calcifications or fat components) and almost certainly benign nodules based on other benign-appearing imaging features. All noncalcified lung nodules on the CT scans were noted and correlated with the final diagnosis. Data analysis The size of each identified nodule was manually measured as the average of the longest long-axis diameter and the longest short-axis diameter in any one CT section. The size of the largest nodule and the number of all noncalcified nodules with size 2 49 mm were correlated with the final diagnosis. The features of malignancy and benignancy were compared in terms of small (\10 mm) versus large (C10 mm) nodules and solitary versus multiple nodules. The presence of nodular metastases from breast cancer on the chest CT scans was correlated with breast cancer cell grade and clinical stage. A Chi square test for independence was used to compare the benign nodules and the malignant nodules and to compare metastatic nodules from breast cancer and nodular lung cancers based on (1) size (small vs. large) and (2) number (solitary vs. multiple). The Chi square test was also used to compare the patients with lung metastases from breast cancer and patients without lung metastases based on (1) breast cancer cell grade (grade 1 2 vs. grade 3) and (2) clinical stage (stage 0 1 vs. stage 2 3). Results Of the 1325 patients, 812 patients (61 %) had a CT scan acquired during the study period with at least one noncalcified lung nodule (Fig. 1). The remaining 513 (39 %) patients had no lung nodules in any CT scan acquired during the study period. From each of the 812 patients, the first (i.e., earliest) scan in which noncalcified nodules were retrospectively visible was used for analysis. The malignant nodule was used for the analysis if a scan had both malignant and benign nodules. CT section thickness for these 812 CT scans was 1 mm in 580 (71 %) scans, 2 3 mm in 35 (4 %) scans, 4 5 mm in 181 (22 %) scans, and 7 10 mm in 16 (2 %) scans. The CT scan was acquired less than 1 year prior to the diagnosis of breast cancer in 50 (6.2 %) patients, less than 1 year after the diagnosis of breast cancer in 397 (49 %) patients, and more than 1 year after the diagnosis of breast cancer in the remaining 365 (45 %) patients. The recorded clinical information indicated that 637 (79 %) scans had been acquired primarily for breast cancer staging, 70 (9 %) had been acquired for
3 Breast Cancer Res Treat (2016) 159: Fig. 1 Flow diagram of 1325 breast cancer patients with/without lung nodules on chest CT scans and final diagnosis of 812 patients with lung nodules staging or searching for other cancers, 64 (7.9 %) had been requested to evaluate for lung or cardiac disease, and 41 (5.0 %) had been obtained at outside hospitals without available clinical indication. The final diagnoses of the 812 breast cancer patients with at least one noncalcified lung nodule on a CT scan are detailed in Fig. 1. Among the 812 patients, ten patients with a benign nodule and 27 patients with a malignant nodule also had another benign or malignant nodule that was not included in the data analysis. Considering only the largest noncalcified lung nodule, the final diagnosis included 482 (59 %) benign nodules (225 definitely benign and 257 almost certainly benign lesions) and 330 (41 %) malignant nodules (26 primary lung cancers, 19 suspicious malignant, 41 indeterminate lesions, and 244 nodular metastases). The nodule size characteristics of the 812 breast cancer patients with noncalcified lung nodules on a chest CT scan are summarized in Table 1. Among the 812 patients, 615 (76 %) had small (\10 mm) nodules and 197 (24 %) had large nodules (C10 mm). Smaller nodule size was associated with decreased likelihood of malignancy, except in the mm nodule size group. The percentage of scans with malignant nodules was smaller for scans with mm nodules (67 %) than for scans with mm nodules (79 %) or mm nodules (90 %). Large nodules were more often malignant than were small nodules (80 vs. 28 %, P \ 0.001). Multiplicity of nodules was associated with the size of the largest nodule in the 812 breast cancer patients (Table 2). Among the 812 patients, 226 (28 %) had solitary and 586 (72 %) had multiple nodules. A smaller number of nodules were associated with decreased likelihood of malignancy. In very small nodules (2 4 mm), the malignancy rate of solitary and multiple nodules was 8 and 20 %, respectively. Among 54 patients with 2 4 mm malignant nodules, 36 (67 %) patients had nodular metastases (29 from breast cancer) and 18 (33 %) patients had indeterminate nodules. Multiple nodules (46 %) compared with solitary nodules (26 %) at any size were more often malignant than benign (P \ 0.001). Figure 2 shows a small perifissural nodule in the right lung with no change on follow-up CT scans over 2 years, consistent with an intrapulmonary lymph node. Figure 3 shows metastatic nodules from breast cancer in the right lung with increased size and number on follow-up CT scans. A total of 212 (26 %) of the 812 patients with lung nodules (16 % of all 1325 patients) had lung metastases from breast cancer. Another 32 (3.9 %) of these 812 patients had nodular metastases due to other advanced cancers (nine lung cancers, six gynecologic cancers, six urologic cancers, and 11 cancers of other types). Also, 26 (3.2 %) of these patients had pathology-proven primary lung cancer (mostly adenocarcinoma or nonsmall cell carcinoma). Among patients with small nodules, the percentages of patients with primary nodular lung cancer and nodular metastases from breast cancer were 12 and 49 %, respectively (P = 0.02). Among patients with solitary
4 268 Breast Cancer Res Treat (2016) 159: Table 1 Imaging size characteristics of noncalcified lung nodules on chest CT scans in patients with breast cancer Size of largest nodule (mm) malignant nodules benign nodules Percentage of malignant in patient group (%) Chi square P value 2 4 (N = 345) (N = 270) (N = 111) (N = 41) (N = 33) (N = 12) Small size \10 (N = 615) \0.001 Large size C10 (N = 197) Total (N = 812) Table 2 Nodule numbers compared with largest nodule size on chest CT scans in patients with breast cancer Nodule number (mm) malignant nodules benign nodules Percentage of malignant in patient group (%) Chi square P value Solitary nodule (N = 226) (N = ) (N = 65) mm (N = 38) Multiple 2 6 nodules (N = 372) Multiple [6 nodules (N = 214) (N = 222) (N = 205) (N = 159) Solitary nodule (N = 226) \0.001 Multiple nodules (N = 586) Total (N = 812) nodules across all sizes, the percentages of patients with primary nodular lung cancer and nodular metastases from breast cancer were 46 and 12 %, respectively (P = 0.001). No breast cancer cell grade was specified for 205 (15 %) of all 1325 breast cancer patients with chest CT scans, including 33 (16 %) of the 212 patients with lung metastases from breast cancer. Only seven of the 1325 patients had specified cell grade 4; none of these seven patients was among the 212 patients with lung metastases from breast cancer. These cell grade 4 patients were not used for statistical analysis because this patient group was too small. No clinical stage was specified for 380 (29 %) of all 1325 breast cancer patients with chest CT scans, including 66 (31 %) of the 212 patients with lung metastases from breast cancer. Stage 4 breast cancer was recorded for 168 patients, including 53 of the 212 patients with lung metastases from breast cancer. The rate of lung metastases in patients who had stage 4 breast cancer was 32 % (53/168); the CT scan was acquired less than 1 year prior to the diagnosis of breast cancer in two (3.8 %) patients, less than 1 year after the diagnosis of breast cancer in 43 (81 %) patients, and more than 1 year after the diagnosis of breast cancer in the remaining eight (15 %) patients. Analysis by breast cancer cell grade 1 3 and clinical stage 0 3 in patients with lung metastases on chest CT scans is shown in Table 3. Among the 1113 patients with recorded breast cancer cell grade 1 3, 179 (16 %) patients had lung metastases from breast cancer; the CT scan was acquired less than 1 year prior to the diagnosis of breast cancer in three (1.7 %) patients, less than 1 year after the diagnosis of breast cancer in 67 (37 %) patients, and more than 1 year after the diagnosis of breast cancer in the remaining 109 (61 %) patients. Among the 777 patients with recorded clinical stage 0 3, 93 (12 %) patients had lung metastases from breast cancer; the CT scan was acquired less than 1 year prior to the diagnosis of breast cancer in two (2.2 %) patients, less than 1 year after the diagnosis of breast cancer in 20 (22 %) patients, and more than 1 year after the diagnosis of breast cancer in the remaining 71 (76 %) patients. In further analysis, lung
5 Breast Cancer Res Treat (2016) 159: Fig year-old woman with breast cancer (breast cancer cell grade 2 and clinical stage 2B) a Initial chest CT scan shows a perifissural small nodule in the right lung (arrow) and b Follow-up chest CT scan at 38 months shows stable nodule (probable lymph node) after more than 2 years Fig year-old woman with breast cancer (breast cancer cell grade 3 and clinical stage 2B) a Initial chest CT scan shows two small noncalcified lung nodules in the right lung (arrows) and b Follow-up metastases from breast cancer were found more often with breast cancer cell grade 3 (22 %) than with grade 1 2 (10 %) (P \ 0.001) and also more often when patients were clinical stage 2 3 (14 %) than stage 0 1 (7.9 %) (P = 0.03). Discussion CT screening has been used in the early detection of lung cancers, and these scans detect many noncalcified indeterminate lung nodules; however, only a small proportion of these lung nodules are lung cancers [12, 13]. Based on experience from CT screening for lung cancer, guidelines [14] have been proposed by the Fleischner Society for chest CT scan at 26 months shows multiple nodular metastases from breast cancer management of lung nodules detected on routine CT scans in clinical practice, but these guidelines specifically exclude patients with known malignancy, such as breast cancer. One study previously reported the clinical significance of CT-detected silent lung nodules in patients with early breast cancer [7], and another study reported on the value of a preoperative staging CT scan to detect asymptomatic lung and liver metastases in patients with breast cancer [8]. The resulting analyses in these studies indicated that malignancy rates were less than 20 %, even when including relatively large nodules greater than 10 mm [8]. The current study provides a more detailed analysis (imaging findings, final nodule diagnosis, breast cancer cell grade, and clinical stage) for all malignant nodules (including true breast cancer metastases) and benign nodules
6 270 Breast Cancer Res Treat (2016) 159: Table 3 Analysis for breast cancer cell grade and clinical stage in patients with lung metastases from breast cancer on chest CT scans Patient group No. of patients with lung metastases Percentage of malignant in patient group (%) Chi square P value Breast cancer cell grade 1 3 (N = 1113) Grade 1 2 (N = 541) \0.001 Grade 3 (N = 572) Clinical stage 0 3 (N = 777) Stage 0 1 (N = 278) Stage 2 3 (N = 499) detected by chest CT scans in a large series of patients with proven breast cancer. A previous study that addressed the role of surgery in the management of solitary lung nodules in patients with breast cancer reported that among 79 consecutive patients during a 13-year period: 38 (48 %) patients had primary lung cancer, 27 (34 %) patients had metastatic nodules from breast cancer, and 14 (18 %) patients had benign nodules [15]. Surgical series such as this, however, are inevitably biased toward larger and more suspicious nodules that are judged sufficiently suspicious to merit biopsy or resection. Generally, patients with lung metastases have a much higher frequency of multiple masses/nodules than patients with primary lung cancer [16], and the differentiation of a primary lung cancer from solitary metastatic nodules can be very difficult based on imaging findings alone [17]. Based on both biopsy results and imaging findings, the current study indicated that (1) solitary nodules were more often primary lung cancers (46 %) than breast cancer metastases (12 %) and (2) small nodules were more often metastases (49 %) than primary cancers (12 %). Among the 330 (41 %) patients with malignant lung nodules on CT scans in this series, 212 (26 %) patients had nodular lung metastases from breast cancer (the largest group) and 32 (3.9 %) had lung metastases from other cancers, including lung cancer. Also, 26 (3.2 %) patients had pathology-proven primary lung cancer, which is a lower rate than that found in high-risk smokers enrolled in lung cancer screening programs with a range of % among persons with nodules [18 20]. The remaining 60 (7.4 %) patients had indeterminate or suspicious malignant lesions. The malignant nodules among these different categories were not separated for purposes of analysis in this study, although the treatment plans for the primary and metastatic nodules would be different. Kim et al. [8] reported on stage 1 3 breast cancer patients with lung nodules on staging chest CT scans. Of 163 patients with small nodules\10 mm, the nodules of 19 (12 %) patients were nodular metastases from breast cancer, whereas of 17 patients with large nodules (C10 mm), the nodules of three (18 %) patients were metastases from breast cancer, indicating no significant difference in the proportion of breast cancer metastasis among nodules in these two size categories. Lee et al. [7] reported that among 802 breast cancer patients with staging chest CT scans, 34 (4.2 %) patients had indeterminate lung nodules. The follow-up results showed that among 26 patients with \10 mm nodules, six of seven (86 %) patients with solitary nodules and 17 of 19 (89 %) patients with multiple nodules had benign nodules, whereas among eight patients with C10 mm multiple nodules, all nodules were malignant. The current study showed that among patients with multiple nodules greater than 10 mm, 83 % had malignant nodules, most of which were lung metastases from breast cancer; however, the majority of small lung nodules were benign, and in the case of very small nodules (2 4 mm), the malignancy rate of solitary nodules was only 8 %. Although the results indicate that decreased nodule size and increased nodule number are related to an increased likelihood of benignancy, the percentage (67 %) of malignant nodules in the mm size range was lower than among nodules in the mm size range (79 %) or the mm size range (90 %). Imaging findings suggest that nodules in this size range probably were caused by inflammatory changes during and after chemo or radiation therapy. Chest CT scans can upstage 6 % of stage 3 patients to stage 4 [8], and a metastatic workup, including chest CT, is only considered indicated for N2/N3 breast cancer patients with T3 or T4 primary lesions [10]. In the current study, 16 % of patients with breast cancer cell grade 1 3, and 12 % of patients in clinical stage 0 3 had nodular lung metastases from breast cancer. For most of these patients with lung metastases, the metastatic nodules were not identified in CT exams until [1 year after the diagnosis of breast cancer. Lung metastases from breast cancer were found more often with breast cancer cell grade 3 than grade
7 Breast Cancer Res Treat (2016) 159: and when patients were clinical stage 2 3 rather than stage 0 1. Limitations in this retrospective study included that (1) the time period between CT and diagnosis for breast cancer was not consistent, and (2) imaging techniques for chest CT scans were variable. However, even with these limitations, the current study could determine significance of noncalcified lung nodules on chest CT scans of a large number of patients with breast cancer in routine clinical practice; the imaging findings should help oncologists in managing their concern for metastases to reduce unnecessary patient anxiety. In conclusion, lung metastases were especially likely in patients with multiple nodules greater than 10 mm in size, whereas the large majority of solitary nodules and very small multiple nodules on chest CT scans were benign in breast cancer patients. Increased breast cell grade and clinical stage increased the likelihood of lung metastases in these patients. Acknowledgments Funding This work was supported in part, by a Science Council Research Seed Funding Grant from the American Association of Physicists in Medicine. Compliance with ethical standards Disclosure SG. Armato is a consultant for Aduro Biotech, Inc. M.L. Giger is a shareholder of Hologic and Quantitative Insights. H. MacMahon is a shareholder of Hologic and a consultant for Riverain Technologies. F. Li, S.G. Armato, M.L. Giger, and H. MacMahon receive royalties from multiple companies through The University of Chicago (UC Tech). References 1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Tun MJ (2009) Cancer statistics, CA Cancer J Clin 59: Chen EA, Carlson GA, Coughlin BF, Reed WP, Garb JJL, Frank JL (2000) Routine chest roentgenography is unnecessary in the work-up of stage I and II breast cancer. J Clin Oncol 18: Myers RE, Johnston M, Pritchard K, Levine M, Oliver T, the breast cancer disease site group of the cancer care Ontario practice guidelines initiative (2001) Baseline staging tests in primary breast cancer: a practice guideline. CMAJ 164: Gerber B, Seitz E, Müller H, Krause A, Reimer T, Kundt G, Friese K (2003) Perioperative screening for metastatic disease is not indicated in patients with primary breast cancer and no clinical signs of tumor spread. Breast Cancer Res Treat 82: Puglisi F, Follador A, Minisini AM, Cardellino GG, Russo S, Andreetta C, Terlizzi SD, Piga A (2005) Baseline staging tests after a new diagnosis of breast cancer: further evidence of their limited indications. Annals Oncol 16: Debald M, Wolfgarten M, Kreklau P, Abramian A, Kaiser C, Höller T, Leutner C, Keyver-Paik MD, Braun M, Kuhn W (2014) Staging of primary breast cancer is not indicated in asymptomatic patients with early tumor stages. Oncol Res Treat 37: Lee B, Lim A, Lalvani A, Descamps MJL, Leonard R, Nallamala S, Lewis JS (2008) The clinical significance of radiologically detected silent pulmonary nodules in early breast cancer. Ann Oncol 19: Kim H, Han W, Moon HG, Min J, Ahn SK, Kim TY, Im SA, Oh DY, Han SW, Chie EK, Ha SW, Noh DY (2011) The value of preoperative staging chest computed tomography to detect asymptomatic lung and liver metastases in patients with primary breast carcinoma. Breast Cancer Res Treat 126: Brennan ME, Houssami N (2012) Evaluation of the evidence on staging imaging for detection of asymptomatic distant metastases in newly diagnosed breast cancer. The Breast 21: Chu QD, Henderson A, Kim RH, Miller JK, Burton G, Ampil F, Li BDL (2012) Should a routine metastatic workup be performed for all patients with pathologic N2/N3 breast cancer? J Am Coll Surg 214: James JJ, McMahon MA, Tennant SL, Cornford EJ (2012) CT staging for breast cancer patients with poor prognostic tumours. The Breast 21: Henschke CI, Yankelevitz DF, Mirtcheva R, McGuinness G, McCauley D, Miettinen OS (2002) CT screening for lung cancer: frequency and significance of part-solid and nonsolid nodules. AJR 178: Li F, Sone S, Abe H, MacMahon H, Doi K (2004) Malignant versus benign nodules at CT screening for lung cancer: comparison of thin-section CT findings1. Radiology 233(3): MacMahon H, Austin JHM, Gamsu G, Herold CJ, Jett JR, Naldlch DP, Patz EF Jr, Swensen SJ (2005) Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society. Radiology 237: Rena O, Rapalia E, Ruffini E, Filosso PL, Oliaro A, Maggi G, Casadio C (2007) The role of surgery in the management of solitary pulmonary nodule in breast cancer patients. EJSO 33: Khokhar S, Vickers A, Moore MS, Mironov S, Stover DE, Feinstein MB (2006) Significance of non-calcified pulmonary nodules in patients with extrapulmonary cancers. Thorax 61: Quint LE, Park CH, Lannettonl MD (2000) Solitary pulmonary nodules in patients with extrapulmonary neoplasms. Radiology 217: New York Early Lung Cancer Action Project Investigators (2007) CT screening for lung cancer: diagnoses resulting from the New York early lung cancer action project. Radiology 243: The National Lung Screening Trial Research Team (2013) Results of initial low-dose computed tomographic screening for lung cancer. N Engl J Med 368: McWilliams A, Tammemagi MC, Mayo JR et al (2013) Probability of cancer in pulmonary nodules detected on first screening CT. N Engl J Med 369:
PULMONARY NODULES AND MASSES : DIAGNOSTIC APPROACH AND NEW MANAGEMENT GUIDELINES. https://tinyurl.com/hmpn2018
PULMONARY NODULES AND MASSES : DIAGNOSTIC APPROACH AND NEW MANAGEMENT GUIDELINES Heber MacMahon MB, BCh Department of Radiology The University of Chicago https://tinyurl.com/hmpn2018 Disclosures Consultant
More informationCT Screening for Lung Cancer for High Risk Patients
CT Screening for Lung Cancer for High Risk Patients The recently published National Lung Cancer Screening Trial (NLST) showed that low-dose CT screening for lung cancer reduces mortality in high-risk patients
More informationGUIDELINES FOR PULMONARY NODULE MANAGEMENT : RECENT CHANGES AND UPDATES
Venice 2017 GUIDELINES FOR PULMONARY NODULE MANAGEMENT : RECENT CHANGES AND UPDATES Heber MacMahon MB, BCh Department of Radiology The University of Chicago Disclosures Consultant for Riverain Medical
More informationLearning Objectives. 1. Identify which patients meet criteria for annual lung cancer screening
Disclosure I, Taylor Rowlett, DO NOT have a financial interest /arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context
More informationSmall Pulmonary Nodules: Our Preliminary Experience in Volumetric Analysis of Doubling Times
Small Pulmonary Nodules: Our Preliminary Experience in Volumetric Analysis of Doubling Times Andrea Borghesi, MD Davide Farina, MD Roberto Maroldi, MD Department of Radiology University of Brescia Brescia,
More informationClinical Significance of Lung Nodules Reported on Abdominal CT
Cardiopulmonary Imaging Original Research Alpert et al. Significance of Lung Nodules on Abdominal CT Cardiopulmonary Imaging Original Research Jeffrey B. Alpert 1 John P. Fantauzzi Kira Melamud Heather
More informationGuidelines for the Management of Pulmonary Nodules Detected by Low-dose CT Lung Cancer Screening
Guidelines for the Management of Pulmonary Nodules Detected by Low-dose CT Lung Cancer Screening 1. Introduction In January 2005, the Committee for Preparation of Clinical Practice Guidelines for the Management
More informationTHE BENEFITS OF BIG DATA
THE BENEFITS OF BIG DATA Disclosures I am a named inventor on a number of patents and patent applications relating to the evaluation of pulmonary nodules on CT scans of the chest which are owned by Cornell
More informationPulmonary Nodules & Masses
Pulmonary Nodules & Masses A Diagnostic Approach Heber MacMahon The University of Chicago Department of Radiology Disclosure Information Consultant for Riverain Technology Minor equity in Hologic Royalties
More informationProjected Outcomes Using Different Nodule Sizes to Define a Positive CT Lung Cancer Screening Examination
DOI:10.1093/jnci/dju284 First published online October 20, 2014 The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
More informationSCBT-MR 2016 Lung Cancer Screening in Practice: State of the Art
SCBT-MR 2016 Lung Cancer Screening in Practice: State of the Art Reginald F. Munden MD, DMD, MBA I have no conflicts of interest to report National Lung Cancer Screening Trial 20% lung cancer mortality
More informationMayo Clinic College of Medicine, Rochester, Minnesota, USA
The Oncologist Lung Cancer Commentary: CT Screening for Lung Cancer Caveat Emptor JAMES R. JETT,DAVID E. MIDTHUN Mayo Clinic College of Medicine, Rochester, Minnesota, USA Key Words. CT screening Early
More informationMay-Lin Wilgus. A. Study Purpose and Rationale
Utility of a Computer-Aided Diagnosis Program in the Evaluation of Solitary Pulmonary Nodules Detected on Computed Tomography Scans: A Prospective Observational Study May-Lin Wilgus A. Study Purpose and
More informationSCBT-MR 2015 Incidentaloma on Chest CT
SCBT-MR 2015 Incidentaloma on Chest CT Reginald F. Munden MD, DMD, MBA I have no conflicts of interest to report Incidentaloma Pulmonary Nodule Mediastinal Lymph Node Coronary Artery Calcium Incidental
More informationIdentification of Missed Pulmonary Nodules on Low Dose CT Lung Cancer Screening Studies Using an Automatic Detection System
Identification of Missed Pulmonary Nodules on Low Dose CT Lung Cancer Screening Studies Using an Automatic Detection System Carol L. Novak *a, Li Fan a, Jianzhong Qian a, Guo-Qing Wei a, David P. Naidich
More informationEvidence based approach to incidentally detected subsolid pulmonary nodule. DM SEMINAR July 27, 2018 Harshith Rao
Evidence based approach to incidentally detected subsolid pulmonary nodule DM SEMINAR July 27, 2018 Harshith Rao Outline Definitions Etiologies Risk evaluation Clinical features Radiology Approach Modifications:
More informationCT Screening for Lung Cancer: Frequency and Significance of Part-Solid and Nonsolid Nodules
Claudia I. Henschke 1 David F. Yankelevitz 1 Rosna Mirtcheva 1 Georgeann McGuinness 2 Dorothy McCauley 1 0lli S. Miettinen 3 for the ELCAP Group Received June 19, 2001; accepted after revision November
More informationLoren Ketai, MD; Mathurn Malby, BS; Kirk Jordan, MD; Andrew Meholic, MD; and Julie Locken, MD
Small Nodules Detected on Chest Radiography* Does Size Predict Calcification? Loren Ketai, MD; Mathurn Malby, BS; Kirk Jordan, MD; Andrew Meholic, MD; and Julie Locken, MD Study objectives: To determine
More informationLung Cancer Screening: To Screen or Not to Screen?
Lung Cancer Screening: To Screen or Not to Screen? Lorriana Leard, MD Co-Director of UCSF Lung Cancer Screening Program Vice Chief of Clinical Activities UCSF Pulmonary, Critical Care, Allergy & Sleep
More informationPULMONARY NODULES DETECTED INCIDENTALLY OR BY SCREENING: LOTS OF GUIDELINES BUT WHERE IS THE EVIDENCE?
PULMONARY NODULES DETECTED INCIDENTALLY OR BY SCREENING: LOTS OF GUIDELINES BUT WHERE IS THE EVIDENCE? MICHAEL K. GOULD, MD SENIOR RESEARCH SCIENTIST DIRECTOR FOR HEALTH SCIENCES & IMPLEMENTATION SCIENCE
More informationRole of CT imaging to evaluate solitary pulmonary nodule with extrapulmonary neoplasms
Original Research Article Role of CT imaging to evaluate solitary pulmonary nodule with extrapulmonary neoplasms Anand Vachhani 1, Shashvat Modia 1*, Varun Garasia 1, Deepak Bhimani 1, C. Raychaudhuri
More informationLUNG NODULES: MODERN MANAGEMENT STRATEGIES
Department of Radiology LUNG NODULES: MODERN MANAGEMENT STRATEGIES Christian J. Herold M.D. Department of Biomedical Imaging and Image-guided Therapy Medical University of Vienna Vienna, Austria Pulmonary
More informationUtility and Costs of Routine Staging Scans in Early-Stage Breast Cancer
UTILITY AND COSTS OF ROUTINE STAGING SCANS IN EARLY-STAGE BREAST CANCER Utility and Costs of Routine Staging Scans in Early-Stage Breast Cancer Samuel A. Merrill, MD, PhD, Pamela Stevens, RN, Claire Verschraegen,
More informationUse of contrast-enhanced computed tomography in clinical staging of asymptomatic breast cancer patients to detect asymptomatic distant metastases
772 Use of contrast-enhanced computed tomography in clinical staging of asymptomatic breast cancer patients to detect asymptomatic distant metastases SATORU TANAKA, NAYUKO SATO, HIROYA FUJIOKA, YUKO TAKAHASHI,
More informationApproach to Pulmonary Nodules
Approach to Pulmonary Nodules Edwin Jackson, Jr., DO Assistant Professor-Clinical Director, James Early Detection Clinic Department of Internal Medicine Division of Pulmonary, Allergy, Critical Care and
More informationComparison of RECIST version 1.0 and 1.1 in assessment of tumor response by computed tomography in advanced gastric cancer
Original Article Comparison of RECIST version 1.0 and 1.1 in assessment of tumor response by computed tomography in advanced gastric cancer Gil-Su Jang 1 *, Min-Jeong Kim 2 *, Hong-Il Ha 2, Jung Han Kim
More informationLow-dose CT Lung Cancer Screening Guidelines for Pulmonary Nodules Management Version 2
Low-dose CT Lung Cancer Screening Guidelines for Pulmonary Nodules Management Version 2 The Committee for Management of CT-screening-detected Pulmonary Nodules 2009-2011 The Japanese Society of CT Screening
More informationAfter primary tumor treatment, 30% of patients with malignant
ESTS METASTASECTOMY SUPPLEMENT Alberto Oliaro, MD, Pier L. Filosso, MD, Maria C. Bruna, MD, Claudio Mossetti, MD, and Enrico Ruffini, MD Abstract: After primary tumor treatment, 30% of patients with malignant
More information2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY. MEASURE TYPE: Process
Quality ID #364: Optimizing Patient Exposure to Ionizing Radiation: Appropriateness: Follow-up CT Imaging for Incidentally Detected Pulmonary Nodules According to Recommended Guidelines National Quality
More informationClinical Practice Guidelines - Breast Disease Site. Guideline Title: Staging of Primary Breast Cancer Date: (O): (R):
Guideline Title: Staging of Primary Breast Cancer Date: (O): (R): July 31, 2011 Tumor Group: Breast Disease Site Group Page: 1 of 9 Issuing Authority: Dr. Kara Laing Clinical Chief, Cancer Care Program
More informationDENOMINATOR: All final reports for CT imaging studies with a finding of an incidental pulmonary nodule for patients aged 35 years and older
Quality ID #364: Optimizing Patient Exposure to Ionizing Radiation: Appropriateness: Follow-up CT Imaging for Incidentally Detected Pulmonary Nodules According to Recommended Guidelines National Quality
More informationThe solitary pulmonary nodule: Assessing the success of predicting malignancy
The solitary pulmonary nodule: Assessing the success of predicting malignancy Poster No.: C-0829 Congress: ECR 2010 Type: Scientific Exhibit Topic: Chest Authors: R. W. K. Lindsay, J. Foster, K. McManus;
More informationPET/CT in lung cancer
PET/CT in lung cancer Andrei Šamarin North Estonia Medical Centre 3 rd Baltic Congress of Radiology 08.10.2010 Imaging in lung cancer Why do we need PET/CT? CT is routine imaging modality for staging of
More informationChristine Argento, MD Interventional Pulmonology Emory University
Christine Argento, MD Interventional Pulmonology Emory University Outline Lung Cancer Statistics Prior Studies for Lung Cancer Screening NLST Studies Following NLST Future Directions Lung Cancer American
More informationPre-operative Ultrasound of Lymph Nodes in Thyroid Cancer
Pre-operative Ultrasound of Lymph Nodes in Thyroid Cancer AACE - Advances in Medical and Surgical Management of Thyroid Cancer - 2018 Robert A. Levine, MD, FACE, ECNU Thyroid Center of New Hampshire Geisel
More informationSmall solid noncalcified pulmonary nodules detected by screening chest computed tomography
Respiratory Medicine (2007) 101, 1880 1884 Small solid noncalcified pulmonary nodules detected by screening chest computed tomography Sang-Man Jin a,b, Seung-Ho Choi c, Chul-Gyu Yoo a,b, Young-Whan Kim
More informationThorax Online First, published on February 7, 2006 as /thx Saira Khokhar, M.B.B.S., Andrew Vickers, Ph.D.,
Thorax Online First, published on February 7, 2006 as 10.1136/thx.2005.051508 Significance of Non-Calcified Pulmonary Nodules among Patients with Extra-Pulmonary Cancers Saira Khokhar, M.B.B.S., Andrew
More informationLung Cancer Risk Associated With New Solid Nodules in the National Lung Screening Trial
Cardiopulmonary Imaging Original Research Pinsky et al. Lung Cancer Risk Associated With New Nodules Cardiopulmonary Imaging Original Research Paul F. Pinsky 1 David S. Gierada 2 P. Hrudaya Nath 3 Reginald
More informationAfternoon Session Cases
Afternoon Session Cases Case 1 19 year old woman Presented with abdominal pain to community hospital Mild incr WBC a14, 000, Hg normal, lipase 100 (normal to 75) US 5.2 x 3.7 x 4 cm mass in porta hepatis
More informationComparison of three mathematical prediction models in patients with a solitary pulmonary nodule
Original Article Comparison of three mathematical prediction models in patients with a solitary pulmonary nodule Xuan Zhang*, Hong-Hong Yan, Jun-Tao Lin, Ze-Hua Wu, Jia Liu, Xu-Wei Cao, Xue-Ning Yang From
More informationPET IMAGING (POSITRON EMISSION TOMOGRAPY) FACT SHEET
Positron Emission Tomography (PET) When calling Anthem (1-800-533-1120) or using the Point of Care authorization system for a Health Service Review, the following clinical information may be needed to
More informationSmall cell lung cancer (SCLC) is an aggressive malignancy
BRIEF REPORT Characteristics and Outcomes of Small Cell Lung Cancer Patients Diagnosed During Two Lung Cancer Computed Tomographic Screening Programs in Heavy Smokers Sinead Cuffe, MD,* Teng Moua, MD,
More informationExample of lung screening
Justification of the use of CT for individual health assessment of asymptomatic people How to obtain evidence for IHA - Example of lung screening Mathias Prokop, MD PhD Professor of Radiology Radboud University
More informationComputer-aided Detection of Peripheral Lung Cancers Missed at CT: ROC Analyses without and with Localization 1
Feng Li, MD, PhD Hidetaka Arimura, PhD Kenji Suzuki, PhD Junji Shiraishi, PhD Qiang Li, PhD Hiroyuki Abe, MD, PhD Roger Engelmann, MS Shusuke Sone, MD, PhD Heber MacMahon, MD Kunio Doi, PhD Published online
More informationIndeterminate Pulmonary Nodules in Patients with Colorectal Cancer
Indeterminate Pulmonary Nodules in Patients with Colorectal Cancer Jai Sule 1, Kah Wai Cheong 2, Stella Bee 2, Bettina Lieske 2,3 1 Dept of Cardiothoracic and Vascular Surgery, University Surgical Cluster,
More informationAssessing the Role of Imaging in Primary Breast Cancer Staging. Stuart-Allison M. Staley
Assessing the Role of Imaging in Primary Breast Cancer Staging By Stuart-Allison M. Staley A Master s Paper submitted to the faculty of the University of North Carolina at Chapel Hill in partial fulfillment
More informationPAPER. See Invited Critique at end of article
PAPER Systematic Postoperative Radiologic Follow-up in Patients With Non Small Cell Lung Cancer for Detecting Second Primary Lung Cancer in Stage IA Jeffrey P. Lamont, MD; James T. Kakuda, MD; David Smith,
More informationUtility of 18 F-FDG PET/CT in metabolic response assessment after CyberKnife radiosurgery for early stage non-small cell lung cancer
Utility of F-FDG PET/CT in metabolic response assessment after CyberKnife radiosurgery for early stage non-small cell lung cancer Ngoc Ha Le 1*, Hong Son Mai 1, Van Nguyen Le 2, Quang Bieu Bui 2 1 Department
More informationClinical significance of indeterminate pulmonary nodules in patients with locally advanced head and neck squamous cell carcinoma
ORIGINAL ARTICLE Clinical significance of indeterminate pulmonary nodules in patients with locally advanced head and neck squamous cell carcinoma Raphael E. Alford, MD, MA, 1 David V. Fried, BS, 2 Benjamin
More informationPET CT for Staging Lung Cancer
PET CT for Staging Lung Cancer Rohit Kochhar Consultant Radiologist Disclosures Neither I nor my immediate family members have financial relationships with commercial organizations that may have a direct
More informationThe availability of computed tomography for pulmonary staging in colorectal cancer
ORIGINAL ARTICLE pissn 2288-6575 eissn 2288-6796 http://dx.doi.org/10.4174/astr.2014.86.4.212 Annals of Surgical Treatment and Research The availability of computed tomography for pulmonary staging in
More informationPublished Pulmonary Nodule Guidelines A Synthesis
Published Pulmonary Nodule Guidelines A Synthesis Dr A Devaraj Royal Brompton Hospital London 4/28/2015 1 And very soon to be published Published ^ Pulmonary Nodule Guidelines A Synthesis Dr A Devaraj
More informationMANAGEMENT RECOMMENDATIONS
1 MANAGEMENT RECOMMENDATIONS 1. Adrenal masses!!!!!!! page 2 2. Liver Masses!!!!!!! page 3 3. Obstetric US Soft Markers for Aneuploidy!! pages 4-6 4. Ovarian and Adnexal Cysts!!!!! pages 7-10 5. Pancreatic
More informationRobert J. McKenna M.D. Chief, Thoracic Surgery Cedars Sinai Medical Center
You Smoke, You Get Lung Cancer, You Die: Can Screening Change this Paradigm? Robert J. McKenna M.D. Chief, Thoracic Surgery Cedars Sinai Medical Center AATS Saturday 4/28/2012 Cancer Screening Cancer
More informationThe Frequency and Significance of Small (15 mm) Hepatic Lesions Detected by CT
535 Elizabeth C. Jones1 Judith L. Chezmar Rendon C. Nelson Michael E. Bernardino Received July 22, 1991 ; accepted after revision October 16, 1991. Presented atthe annual meeting ofthe American Aoentgen
More informationA Comprehensive Cancer Center Designated by the National Cancer Institute
N C I C C C A Comprehensive Cancer Center Designated by the National Cancer Institute Screening and Early Detection of Lung Cancer: Ready for Practice? David S. Ettinger, MD, FACP, FCCP Alex Grass Professor
More informationScreening Programs background and clinical implementation. Denise R. Aberle, MD Professor of Radiology and Engineering
Screening Programs background and clinical implementation Denise R. Aberle, MD Professor of Radiology and Engineering disclosures I have no disclosures. I have no conflicts of interest relevant to this
More informationUltrasound for Pre-operative Evaluation of Well Differentiated Thyroid Cancer
Ultrasound for Pre-operative Evaluation of Well Differentiated Thyroid Cancer Its Not Just About the Nodes AACE Advances in Medical and Surgical Management of Thyroid Cancer - 2017 Robert A. Levine, MD,
More informationAn Introduction to PET Imaging in Oncology
January 2002 An Introduction to PET Imaging in Oncology Janet McLaren, Harvard Medical School Year III Basics of PET Principle of Physiologic Imaging: Allows in vivo visualization of structures by their
More informationDiffuse high-attenuation within mediastinal lymph nodes on non-enhanced CT scan: Usefulness in the prediction of benignancy
Diffuse high-attenuation within mediastinal lymph nodes on non-enhanced CT scan: Usefulness in the prediction of benignancy Poster No.: C-1785 Congress: ECR 2012 Type: Authors: Keywords: DOI: Scientific
More informationRadiological staging of lung cancer. Shukri Loutfi,MD,FRCR Consultant Thoracic Radiologist KAMC-Riyadh
Radiological staging of lung cancer Shukri Loutfi,MD,FRCR Consultant Thoracic Radiologist KAMC-Riyadh Bronchogenic Carcinoma Accounts for 14% of new cancer diagnoses in 2012. Estimated to kill ~150,000
More informationProportion and characteristics of transient nodules in a retrospective analysis of pulmonary nodules
Thoracic Cancer ISSN 1759-7706 ORIGINAL ARTICLE Proportion and characteristics of transient nodules in a retrospective analysis of pulmonary nodules Jin-Yeong Yu 1, Boram Lee 1, Sunmi Ju 1, Eun-Young Kim
More informationLos Angeles Radiological Society 62 nd Annual Midwinter Radiology Conference January 31, 2010
Los Angeles Radiological Society 62 nd Annual Midwinter Radiology Conference January 31, 2010 Self Assessment Module on Nuclear Medicine and PET/CT Case Review FDG PET/CT IN LYMPHOMA AND MELANOMA Submitted
More informationFDG PET/CT STAGING OF LUNG CANCER. Dr Shakher Ramdave
FDG PET/CT STAGING OF LUNG CANCER Dr Shakher Ramdave FDG PET/CT STAGING OF LUNG CANCER FDG PET/CT is used in all patients with lung cancer who are considered for curative treatment to exclude occult disease.
More informationREVIEW. Distinguishing benign from malignant adrenal masses
Cancer Imaging (2003) 3, 102 110 DOI: 10.1102/1470-7330.2003.0006 CI REVIEW Distinguishing benign from malignant adrenal masses Isaac R Francis Professor of Radiology, Department of Radiology, University
More informationThe Spectrum of Management of Pulmonary Ground Glass Nodules
The Spectrum of Management of Pulmonary Ground Glass Nodules Stanley S Siegelman CT Society 10/26/2011 No financial disclosures. Noguchi M et al. Cancer 75: 2844-2852, 1995. 236 surgically resected peripheral
More informationMalignant solitary pulmonary nodules: assessment of mass growth rate and doubling time at follow-up CT
Original Article Malignant solitary pulmonary nodules: assessment of mass growth rate and doubling time at follow-up CT Jingxu Li*, Tingting Xia*, Xinguan Yang, Xiao Dong, Jiamin Liang, Nanshan Zhong,
More informationPulmonary Nodules. Michael Morris, MD
Pulmonary Nodules Michael Morris, MD Case 45 year old healthy male Smokes socially Normal physical exam Pre-employment screening remote +PPD screening CXR nodular opacity Case 45 year old healthy male
More informationChapter 5. Pulmonary nodules detected at lung cancer screening: Interobserver variability of semiautomated volume measurements
Chapter 5 Pulmonary nodules detected at lung cancer screening: Interobserver variability of semiautomated volume measurements Hester Gietema Ying Wang Dongming Xu Rob van Klaveren Harry de Koning Ernst
More informationperformed to help sway the clinician in what the appropriate diagnosis is, which can substantially alter the treatment of management.
Hello, I am Maura Polansky at the University of Texas MD Anderson Cancer Center. I am a Physician Assistant in the Department of Gastrointestinal Medical Oncology and the Program Director for Physician
More informationLung Cancer Screening
Scan for mobile link. Lung Cancer Screening What is lung cancer screening? Screening examinations are tests performed to find disease before symptoms begin. The goal of screening is to detect disease at
More informationLung Cancer Screening
Lung Cancer Screening Steven Leh, MD, FCCP Diplomat of the American Association for Bronchology and Interventional Pulmonology Aurora Medical Group Pulmonary and Sleep Medicine February 10, 2018 Disclosures
More informationOriginal Article Clinical predictors of lymph node metastasis in lung adenocarcinoma: an exploratory study
Int J Clin Exp Med 2016;9(5):8765-8769 www.ijcem.com /ISSN:1940-5901/IJCEM0017315 Original Article Clinical predictors of lymph node metastasis in lung adenocarcinoma: an exploratory study Zhijun Zhu,
More informationA review of the issues surrounding incidental findings on CT attenuation. correction (CTAC ) images during SPECT myocardial perfusion imaging
A review of the issues surrounding incidental findings on CT attenuation correction (CTAC ) images during SPECT myocardial perfusion imaging Coward, J Title Authors Type URL A review of the issues surrounding
More informationLOW DOSE SPIRAL COMPUTERIZED TOMOGRAPHY (LDCT) SCREENING FOR LUNG CANCER
LOW DOSE SPIRAL COMPUTERIZED TOMOGRAPHY (LDCT) SCREENING FOR LUNG CANCER A Technology Assessment INTRODUCTION The California Technology Assessment Forum is requested to review the scientific evidence for
More informationStaging Colorectal Cancer
Staging Colorectal Cancer CT is recommended as the initial staging scan for colorectal cancer to assess local extent of the disease and to look for metastases to the liver and/or lung Further imaging for
More informationLung Cancer Imaging. Terence Z. Wong, MD,PhD. Department of Radiology Duke University Medical Center Durham, NC 9/9/09
Lung Cancer Imaging Terence Z. Wong, MD,PhD Department of Radiology Duke University Medical Center Durham, NC 9/9/09 Acknowledgements Edward F. Patz, Jr., MD Jenny Hoang, MD Ellen L. Jones, MD, PhD Lung
More informationCharles Mulligan, MD, FACS, FCCP 26 March 2015
Charles Mulligan, MD, FACS, FCCP 26 March 2015 Review lung cancer statistics Review the risk factors Discuss presentation and staging Discuss treatment options and outcomes Discuss the status of screening
More informationScreening for Lung Cancer: Are We There Yet?
Screening for Lung Cancer: Are We There Yet? Kavita Garg, MD Professor of Radiology University of CO, Denver Mountain States Cancer Conference Nov 6 th 2010 The Epidemiology of Lung Cancer Tobacco is the
More informationManagement of Neck Metastasis from Unknown Primary
Management of Neck Metastasis from Unknown Primary.. Definition Histologic evidence of malignancy in the cervical lymph node (s) with no apparent primary site of original tumour Diagnosis after a thorough
More informationOBJECTIVES. Solitary Solid Spiculated Nodule. What would you do next? Case Based Discussion: State of the Art Management of Lung Nodules.
Organ Imaging : September 25 2015 OBJECTIVES Case Based Discussion: State of the Art Management of Lung Nodules Dr. Elsie T. Nguyen Dr. Kazuhiro Yasufuku 1. To review guidelines for follow up and management
More informationLung Cancer Screening
Scan for mobile link. Lung Cancer Screening What is lung cancer screening? Screening examinations are tests performed to find disease before symptoms begin. The goal of screening is to detect disease at
More informationLung Cancer Screening: Now What?
Lung Cancer Screening: Now What? Gerold Bepler, M.D., Ph.D. Director, President & CEO Michigan Cancer Consortium, 2013 Annual Meeting, Lansing, MI, 11/20/13 Lung Cancer #1 Cause of Cancer Death for & *
More informationXiaohuan Pan 1,2 *, Xinguan Yang 1,2 *, Jingxu Li 1,2, Xiao Dong 1,2, Jianxing He 2,3, Yubao Guan 1,2. Original Article
Original Article Is a 5-mm diameter an appropriate cut-off value for the diagnosis of atypical adenomatous hyperplasia and adenocarcinoma in situ on chest computed tomography and pathological examination?
More informationRodney C Richie MD FACP FCCP DBIM Texas Life and EMSI
Rodney C Richie MD FACP FCCP DBIM Texas Life and EMSI Pulmonary Nodules Well-circumscribed, radiographic opacities measuring 3 cm in diameter Surrounded by aerated lung Not associated with atelectesis
More informationCharacteristics of Subsolid Pulmonary Nodules Showing Growth During Follow-up With CT Scanning
CHEST Original Research Characteristics of Subsolid Pulmonary Nodules Showing Growth During Follow-up With CT Scanning Haruhisa Matsuguma, MD ; Kiyoshi Mori, MD ; Rie Nakahara, MD ; Haruko Suzuki, MD ;
More informationLung cancer screening: are we ready now?
Mini-review Lung cancer screening: are we ready now? Gianluca Milanese Giovanni Capretti Nicola Sverzellati Mario Silva Section of Radiology, Department of Surgical Sciences, University Hospital of Parma,
More informationVolume and Mass Doubling Times of Persistent Pulmonary Subsolid Nodules Detected in Patients without Known Malignancy 1
Note: This copy is for your personal non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, contact us at www.rsna.org/rsnarights. Original Research
More informationTreatment of oligometastatic NSCLC
Treatment of oligometastatic NSCLC Jarosław Kużdżał Department of Thoracic Surgery Jagiellonian University Collegium Medicum, John Paul II Hospital, Cracow New idea? 14 NSCLC patients with solitary extrathoracic
More informationDiagnosis and Staging of Non-Small Cell Lung Cancer Carlos Eduardo Oliveira Baleeiro, MD. November 18, 2017
Diagnosis and Staging of Non-Small Cell Lung Cancer Carlos Eduardo Oliveira Baleeiro, MD November 18, 2017 Disclosures I do not have a financial interest/arrangement or affiliation with one or more organizations
More informationGuidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society
This copy is for personal use only. To order printed copies, contact reprints@rsna.org Heber MacMahon, MB, BCh David P. Naidich, MD Jin Mo Goo, MD, PhD Kyung Soo Lee, MD, PhD Ann N. C. Leung, MD John R.
More informationAdam J. Hansen, MD UHC Thoracic Surgery
Adam J. Hansen, MD UHC Thoracic Surgery Sometimes seen on Chest X-ray (CXR) Common incidental findings on computed tomography (CT) chest and abdomen done for other reasons Most lung cancers discovered
More informationpulmonary metastasis 80EE4727C6037E7F69A9981B7E55A238 Pulmonary Metastasis 1 / 6
Pulmonary Metastasis 1 / 6 2 / 6 3 / 6 Pulmonary Metastasis Metastatic tumors in the lungs are cancers that developed at other places in the body (or other parts of the lungs). They then spread through
More informationA critical review of the chest CT scans performed to detect asymptomatic synchronous metastasis in new and recurrent breast cancers
James et al. World Journal of Surgical Oncology (2019) 17:40 https://doi.org/10.1186/s12957-019-1584-x RESEARCH A critical review of the chest CT scans performed to detect asymptomatic synchronous metastasis
More informationThe long-term course of ground-glass opacities detected on thin-section computed tomography
Respiratory Medicine (2013) 107, 904e910 Available online at www.sciencedirect.com journal homepage: www.elsevier.com/locate/rmed The long-term course of ground-glass opacities detected on thin-section
More informationCopyright 2007 IEEE. Reprinted from 4th IEEE International Symposium on Biomedical Imaging: From Nano to Macro, April 2007.
Copyright 27 IEEE. Reprinted from 4th IEEE International Symposium on Biomedical Imaging: From Nano to Macro, April 27. This material is posted here with permission of the IEEE. Such permission of the
More informationThe Virtual Lung Nodule Clinic
The Virtual Lung Nodule Clinic Poster No.: C-1023 Congress: ECR 2016 Type: Educational Exhibit Authors: S. Higgins, F. C. Lyall, J. Taylor, J. goldman, S. Rolin, B. 1 2 1 2 2 3 2 2 3 Soar ; Torbay/UK,
More informationRole of CT in Lung Cancer Screening: 2010 Stuart S. Sagel, M.D.
Role of CT in Lung Cancer Screening: 2010 Stuart S. Sagel, M.D. Lung Cancer 219,440 new cases/year in U.S. (2009) 169,390 deaths/year in U.S. mortality greater than from breast, colon, prostate CA combined
More informationDr Sneha Shah Tata Memorial Hospital, Mumbai.
Dr Sneha Shah Tata Memorial Hospital, Mumbai. Topics covered Lymphomas including Burkitts Pediatric solid tumors (non CNS) Musculoskeletal Ewings & osteosarcoma. Neuroblastomas Nasopharyngeal carcinomas
More information