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A. Bitencourt
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P2.13 - Radiology/Staging/Screening (ID 714)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.13-020 - Lung-RADS Used in Lung Cancer Screening: Does Granulomatous Disease Intereferes with the Results? Initial Findings at a Brazilian Cancer Center (ID 10327)
09:30 - 09:30 | Author(s): A. Bitencourt
- Abstract
Background:
Lung cancer is the leading cause of cancer death in the world. Screening has proved effective in reducing mortality in one major trial. In countries where granulomatous disease is prevalent, CT-screening false positive results may increase, even when Lung-RADS is used in the screening-CT analysis. Purpose: To analyze the outcomes of low-dose computed tomography (LDCT) lung cancer screening using Lung CT Screening Reporting and Data System (Lung-RADS) at a Brazilian cancer center.
Method:
Medical records of 552 patients initially selected to baseline LDCT- lung-cancer-screening program between May/2016 and April/2017 were analyzed. Only 287 patients complied NLST[1 ]inclusion criteria and were included in the study. These had a mean age of 61.8 years and a history of smoking of a mean of 45.3 pack-year. Mean Dose Length Product (DLP) of LDCT was 21.3 mGy/cm[2] with a mean effective dose of 0.30 mSv. LDCT findings were classified according to Lung-RADS[2] assessment categories.
Result:
Most patients (n=207; 72.1%) had a negative screening CT (Lung-RADS categories 1 or 2), 55 (19.2%) had probably benign findings (Lung-RADS category 3) and 25 (8.7%) had suspicious findings (Lung-RADS categories 4A [5.6%], 4B [2.1%] and 4X [1.0%]). The most common finding was a solid nodule (64.1%), followed by non-solid nodule (8.7%) and then by part solid nodule (2.8%). One patient classified as Lung-RADS category 3S had an incidental diagnosis of chest wall lymphoma, confirmed after biopsy. Patients in Lung-RADS category 4A (n=9) had a CT follow-up and most of them (n=7) showed stable findings and in two patient the nodules increased in size on follow-up CT. Histologic results confirmed lung cancer in 2 cases (prevalence of 0.7% of all screened patients).
Conclusion:
Lung cancer prevalence in our sample was compatible with the literature. However, we had a higher prevalence of Lung-RADS categories 3 and 4A than expected[3]. This may be associated with the higher incidence of granulomatous disease, especially tuberculosis, in the Brazilian population. 1.National Lung Screening Trial Research Team, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011 Aug 4;365(5):395-409. doi: 10.1056/NEJMoa1102873. 2.American College of Radiology. Lung CT Screening Reporting and Data System (Lung-RADS) 3.Pinsky PF, et al. Performance of Lung-RADS in the National Lung Screening Trial: a retrospective assessment. Ann Intern Med 2015 Apr 7;162(7):485-491 doi: 10.7326/M14-2086.
