Change in density of small-indeterminate solid lung nodules across lung cancer screening rounds is related to risk of malignancy.

lung cancer screening computed tomography (CT)

Prof. dr. M. Oudkerk
dr. R. Vliegenhart
M.A. Heuvelmans

Nature of the research:
Retrospective analysis in an ongoing population based study

Fields of study:
pulmonology oncology radiology

Background / introduction
Lung cancer is the most common cause of cancer related death worldwide. Lung cancer is usually in an advanced stage at time of diagnosis, and has a very low 5-year survival rate. Early detection of lung cancer by screening high-risk (ex)smokers with low-dose computed tomography (CT) may reduce lung cancer mortality. The Nederlands-Leuvens Longkanker Screening Onderzoek (NELSON), launched in 2003, is an ongoing multicentre randomized controlled low-dose CT lung cancer screening trial. It is a collaboration between medical centres in Groningen, Rotterdam, Utrecht, Haarlem and Leuven. The NELSON trial is the first large trial in which lung nodule management is based on nodule volume and volume doubling time of the existing nodules. The primary object is to investigate whether chest CT screening in high-risk (ex)-smokers will decrease lung cancer mortality by at least 25% compared to a control group receiving no screening. Nearly 8000 individuals have received CT screening. Results from the CT screening evaluations are available in a large database.
Research question / problem definition
Most screening participants had one or more lung nodules. The majority of these nodules are benign. Especially discriminating between benign and malignant intermediate-sized nodules is a challenge. Better discrimination of benign and malignant lung nodules based on the CT examination could prevent further (invasive) work up and therapy in individuals with a benign lung abnormality. We hypothesize that the change in density on CT-images of small-indeterminate solid lung nodules across screening rounds is related to the risk of malignancy.
An extensive database is available that includes information of all nodules detected in lung cancer screening, as well as the lung cancers in the NELSON trial. First, the student will read literature and visit clinical departments (radiology, pulmonology, lung cancer case panel) to become familiar with the topic. Then, the dataset will be analysed to answer the research question. Finally, the student will present and discuss the results in a manuscript/article.
van Klaveren RJ, Oudkerk M, Prokop M, Scholten ET, Nackaerts K, Vernhout R, et al. Management of lung nodules detected by volume CT scanning. N Engl J Med 2009 Dec 3;361(23):2221-2229.
Xu DM, van Klaveren RJ, de Bock GH, Leusveld AL, Dorrius MD, Zhao Y, et al. Role of baseline nodule density and changes in density and nodule features in the discrimination between benign and malignant solid indeterminate pulmonary nodules. Eur J Radiol 2009 Jun;70(3):492-498.
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Laatst gewijzigd: 23 februari 2012