Noninvasive Characterization of Indeterminate Pulmonary Nodules Detected on Chest High-Resolution Computed Tomography
Technical Report,30 Sep 2017,29 Sep 2018
Vanderbilt University Medical Center Nashville United States
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The widespread implementation of lung cancer screening, following favorable results of the National Lung Screening Trial NLST and more recently the European NELSON trial, will likely continue to exacerbate the widespread clinical problem of indeterminate pulmonary nodules, which were detected in 40 percent of high-risk individuals screened by low dose high-resolution computed tomography HRCT in the NLST. Because 96 percent of these nodules were benign, the issue of diagnostic resolution of incidentally and screen-identified lung nodules will become increasingly important. Current clinical and radiological risk prediction models, which allow risk-stratification of patients and individualize management of pulmonary nodules, are commonly used, but remain suboptimal, and optimization of the clinical management of larger greater than or equal 7 mm screen-detected nodules is urgently needed to avoid unnecessary diagnostic interventions leading to unwarranted mortality, morbidity and healthcare costs. In our project, we explore the utility of a conventional radiomic approach to the classification of screen-detected indeterminate nodules, leveraging unexploited large datasets contained on digital HRCT images to estimate the probability of malignancy based on selected predictive quantitative radiologic features.
- Medicine and Medical Research