Optimum diameter threshold for lung nodules at baseline lung cancer screening with low-dose chest CT: exploration of results from the Korean Lung Cancer Screening Project

Authors
Eui Jin Hwang, Jin Mo Goo, Hyae Young Kim, Jaeyoun Yi, Yeol Kim
Journal
European Radiology
Related Product

LCS

Date Published
2021. 03
Summary

This study aimed to identify the optimal diameter threshold for defining positive results in solid nodules at baseline screening low-dose CT (LDCT) and to compare the effectiveness of two-dimensional and volumetric measurements of lung nodules in diagnosing lung cancers. The study population consisted of consecutive participants from the Korean Lung Cancer Screening project between 2017 and 2018. Semi-automated segmentation was used to measure the average transverse diameter and effective diameter of lung nodules using the A-view Lungscreen software from Coreline Soft. The diagnostic performances for lung cancers, diagnosed within 1 year after LDCT, were evaluated using area under receiver-operating characteristic curves (AUCs), sensitivities, and specificities. The study found that elevating the diameter threshold for solid nodules from 6 to 9 mm could significantly increase the specificity and modestly reduce sensitivity, resulting in a 60.2% estimated reduction of unnecessary follow-up LDCTs, and a diagnostic delay in 1.9% of lung cancers. Thus, the results suggest that increasing the diameter threshold for solid nodules may lead to a substantial decrease in unnecessary follow-up LDCTs with a small proportion of diagnostic delay of lung cancers.

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