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Am J Respir Crit Care Med. 2012 Jan 1;185(1):85-9. doi: 10.1164/rccm.201107-1223OC.

Doubling times and CT screen–detected lung cancers in the Pittsburgh Lung Screening Study.

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  • 1Department of Medicine, Heart, Lung and Esophageal Surgery Institute, University of Pittsuburgh, Pittsburgh, PA 15232, USA. wilsondo@upmc.edu

Abstract

RATIONALE:

As computed tomography (CT) screening for lung cancer becomes more widespread, volumetric analyses, including doubling times, of CT-screen detected lung nodules and lung cancers may provide useful information in the follow-up and management of CT-detected lung nodules and cancers.

OBJECTIVES:

To analyze doubling times in CT screen detected lung cancers and compare prevalent and nonprevalent cancers and different cell types on non small cell lung cancer.

METHODS:

We performed volumetric and doubling time analysis on 63 non–small cell lung cancers detected as part of the Pittsburgh Lung Screening Study using a commercially available VITREA 2 workstation and VITREA VITAL nodule segmentation software.

MEASUREMENTS AND MAIN RESULTS:

Doubling times (DT) were divided into three groups: rapid (DT<183 d), typical (DT 183–365 d), and slow (DT>365 d). Adenocarcinoma/bronchioloalveolar carcinoma comprised 86.7% of the slow DT group compared with 20% of the rapid DT group. Conversely, squamous cell cancer comprised 60% of the rapid DT group compared with 3.3% of the slow DT group. Twenty-eight of 42 (67%) prevalent and 2 of 21 (10%) nonprevalent cancers were in the slow DT group (P<0.0001; Fisher's exact test). Twenty-four of 32 (75%) prevalent and 1 of 11 (9%) nonprevalent adenocarcinomas were in the slow DT group (P<0.0002; Fisher's exact test).

CONCLUSIONS:

Volumetric analysis of CT-detected lung cancers is particularly useful in AC/BAC. Prevalent cancers have a significantly slower DT than nonprevalent cancers and a higher percentage of adenocarcinoma/bronchioloalveolar carcinoma. These results should affect the management of indeterminant lung nodules detected on screening CT scans.

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PMID:
21997335
[PubMed - indexed for MEDLINE]
PMCID:
PMC3262038
Free PMC Article

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