Lung Nodule Management in Low-Dose CT Screening for Lung Cancer: Lessons from the NELSON Trial

Danrong Zhong et al. reviewed the lung nodule management strategies from the NELSON trial, which optimized low-dose CT (LDCT) screening for lung cancer. By implementing semiautomated software for volumetric nodule measurements, the trial minimized false positives (1.2%) while maintaining high sensitivity (95.3%). Key protocols included using volume doubling time (VDT) for nodule growth assessment and stratifying nodules into categories based on volume. This approach enhanced specificity in detecting malignancy and reduced unnecessary invasive procedures. The study highlighted the importance of differentiating benign from malignant nodules, managing subsolid nodules through long-term follow-up, and tailoring screening intervals to new nodule characteristics. AVIEW software was referenced for supporting volumetric assessments, aligning with evolving global guidelines like Lung-RADS and EUPS. The findings provide a roadmap for efficient, personalized lung cancer screening programs. Future research may explore integrating artificial intelligence for better risk stratification and cost-effectiveness analysis.