Authors: J C M van de Wiel Y Wang D M Xu H J van der ZaagLoonen E J van der Jagt R J van Klaveren M Oudkerk on behalf of the NELSON study group
Publish Date: 2007/01/06
Volume: 17, Issue: 6, Pages: 1474-1482
Abstract
The purpose of this study was to prospectively determine the frequency and spectrum of incidental findings IFs and their clinical implications in a high risk population for lung cancer undergoing lowdose multidetector computed tomography MDCT screening for lung cancer Scans of 1929 participants were evaluated for lung lesions and IFs by two radiologists IFs were categorised as not clinically relevant or possibly clinically relevant Findings were considered possibly clinically relevant if they could require further evaluation or could have substantial clinical implications All possibly clinically relevant IFs were reviewed by a third radiologist who determined its clinical relevance Of all 1929 participants 1410 73 had not clinically relevant IFs and 163 8 had possibly clinically relevant IFs of which 129 79 were indeed considered clinically relevant Additional imaging was performed mainly by ultrasound 112 of 118 96 All but one lesion were concluded to be benign mostly cysts n = 115 80 Only 21 1 participants had findings with clinical implications In one participant a malignancy was found yet without any clinical benefit since no curative treatment was possible Based on our results we advise against systematically searching for and reporting of IFs in lung cancer screening studies using lowdose MDCTDutchBelgian lung cancer screening trial four participating hospitals of which three are located in The Netherlands University Medical Centre Groningen University Medical Centre Utrecht Kennemer Gasthuis Haarlem and one in Belgium University Hospital Gasthuisberg LeuvenThe NELSON study group consists of HJ de Koning Dept of Public Health Erasmus Medical Centre Rotterdam HJM Groen Dept of Pulmonology University Medical Centre Groningen WPThM Mali Dept of Radiology University Medical Centre Utrecht WM Prokop Dept of Radiology University Medical Centre Utrecht JWJ Lammers Dept of Pulmonology University Medical Centre Utrecht ETh Scholten Dept of Radiology Kennemer Gasthuis Haarlem C Weenink Dept of Pulmonology Kennemer Gasthuis Haarlem E Thunissen Dept of Pathology CanisiusWilhelmina Hospital Nijmegen J Verschakelen Dept of Radiology University Hospital Gasthuisberg Leuven K Nackaerts Dept of Pulmonology University Hospital Gasthuisberg LeuvenThe NELSON trial is financially supported by Zorg Onderzoek NederlandMedische Wetenschappen ZonMW Dutch Cancer Society NKBKWF Rotterdam Oncologic Thoracic Study Group ROTS Erasmus Trust Fund G Ph Verhagen Foundation Flemish AntiCancer Alliance VLK Stichting Centraal Fonds Reserves van Voormalig Vrijwillige Ziekenfondsverzekeringen RvvZ and Siemens Germany
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