Wednesday, December 2, 2009
WEDNESDAY, Dec. 2 (HealthDay News) -- In patients at high risk for lung cancer, volume computed tomography (CT) scanning of non-calcified pulmonary nodules over time may provide important diagnostic information, according to a study in the Dec. 3 New England Journal of Medicine.
Using software to assess nodule volume or volume-doubling time, Rob J. van Klaveren, M.D., of the Erasmus Medical Center in Rotterdam, Netherlands, and colleagues studied 7,557 patients who were enrolled in a randomized trial of lung-cancer screening and underwent CT screening in years one, two, and four. They defined the first-round screening test as negative if nodule volume was either less than 50 mm3 or 50 to 500 mm3 but had not grown by the time of the three-month follow-up CT, or, if the nodule had grown, the volume-doubling time was 400 days or greater. They defined growth as a volume increase between two scans of at least 25 percent.
The researchers identified positive test results in 2.6 percent of round-one screenings and 1.8 percent of round-two screenings, and determined that the round-one sensitivity and negative predictive value were 94.6 and 99.9 percent, respectively. After two years of follow-up, they detected 20 lung cancers in 7,361 subjects with a negative round-one screening result.
The authors of an accompanying editorial state that these "results suggest that the efficiency of the diagnostic workup for lung cancer can be improved by integrating the measurement of volume growth of lung nodules as an indicator of clinically significant lung cancer while limiting the need for additional costly or potentially harmful diagnostic procedures."
Several authors of the study and editorial reported financial relationships with pharmaceutical companies.
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