CT-detected lung nodules in the general population: prevalence and characteristics

lung cancer screening computed tomography (CT)

dr. R. Vliegenhart
M.A. Heuvelmans
dr. G.J. Pelgrim
dr. M. Rook

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

Fields of study:
pulmonology oncology radiology

Background / introduction
Lung nodules are an extremely common incidental finding in patients who undergo a chest computed tomography (CT). From lung cancer screening studies, we know that in a high-risk population of heavy smokers around 50% have at least one small-to-intermediate sized nodules and a quarter have at least two such nodules (1). Less than 1% of these nodules are malignant (2). Lung cancer probability is based on different lung cancer characteristics, most importantly nodule size and volume-doubling time.
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 adequate management of incidentally detected nodules is therefore extremely important.

Lung nodules are found in the general population, at lower risk of lung cancer development, as well. Since lung cancer risk of these nodules is probably even lower, a different (less stringent) nodule management protocol might be appropriate.
Research question / problem definition
Currently, knowledge on the prevalence and characteristics of incidentally detected lung nodules in a general population (low lung cancer risk, mainly non-smokers, aged 45-55) is limited. In this project, we aim to assess reference values for the presence, characteristics, and lung cancer risk of lung nodules in the general population.
Data from the ImaLife (Imaging in Lifelines) study will be used. First, the student will read literature and visit clinical departments (radiology, pulmonology, lung cancer case panel) to become familiar with the topic. Then, the ImaLife data will be analysed to answer the research question. Finally, the student will present and discuss the results in a report/manuscript.
1) Heuvelmans MA, Walter JE, Peters RB, de Bock GH, Yousaf-Khan U, van der Aalst CM, et al. Relationship between nodule count and lung cancer probability in baseline CT lung cancer screening: The NELSON study. Lung Cancer 2017;113:45-50
2) Horeweg N*, van Rosmalen J*, Heuvelmans MA, van der Aalst CM, Vliegenthart R, Scholten ET, et al. Lung cancer probability in patients with CT-detected pulmonary nodules: a prespecified analysis of data from the NELSON trial of low-dose CT screening. Lancet Oncol 2014 Nov;15(12):1332-1341.
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Laatst gewijzigd: 23 februari 2012