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首页> 外文期刊>Chest >Ability of Low-Dose Helical CT To Distinguish Between Benign and Malignant Noncalcified Lung Nodules
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Ability of Low-Dose Helical CT To Distinguish Between Benign and Malignant Noncalcified Lung Nodules

机译：小剂量螺旋CT分辨良恶性非钙化肺结节的能力

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Study objectives: Low-dose helical CT scanning identifies early stage lung malignancies and alsona large proportion of lung nodules of uncertain diagnostic and prognostic significance (ienindeterminate nodules). The sensitivity, specificity, and predictive value of these indeterminatennodules detected by CT scanning as part of a lung cancer screening program is largely unknownnWe therefore calculated the sensitivity, specificity, and predictive values of CT-detected lungnnodules that were followed up at least 18 months.nDesign: Single-arm screening trial with longitudinal follow-up.nSetting: Rural areas of United States, from 2000 to 2004.nParticipants: Former and current nuclear weapons workers, > 45 years old, including smokersnand never-smokers, with variable exposure to occupational lung carcinogens.nInterventions: A total of 4,401 participants were CT scanned for lung cancer with an initial fulnchest low-dose CT scan, interval CT scans at 3, 6, and 12 months for indeterminate lung nodulesn(eg, nodules not immediately suspicious for lung cancer), and a 18-month, full-chest, low-dosenincidence CT scan.nResults: We achieved follow-up for a minimum of 18 months for > 95% of 807 participants withnindeterminate or suspicious lung nodules. Only 3 of 727 indeterminate nodules were identified asnbeing malignant during the subsequent 18 months. The radiologist’s designation of a nodule asnsuspicious had a sensitivity of 84.2% and a specificity of 96.6%. Given a prior probability of lungncancer of 2.4%, positive and negative predictive values were 37.2% and 99.6%. Overall, wendetected 33 primary lung cancers, including 19 stage I cancers, 5 stage II cancers, 7 stage III-IVncancers, and 3 limited-stage small cell cancers.nConclusions: Helical CT scanning detects many indeterminate nodules, but few are malignantnCT scanning has high sensitivity and specificity to detect early lung cancer. The problem ofnfalse-positive results in helical CT scanning is limited and can be rationally managed. Current CTnfollow-up recommendations are supported. (CHEST 2007; 131:1028–1034)
机译：研究目标：低剂量螺旋CT扫描可识别早期的肺恶性肿瘤，也有很大一部分肺结节具有不确定的诊断和预后意义（不确定结节）。作为肺癌筛查程序的一部分，通过CT扫描检测到的这些不确定的环的敏感性，特异性和预测价值尚不清楚，因此我们计算了至少18个月的CT检测到的肺针的敏感性，特异性和预测值。 n设计：进行纵向随访的单臂筛查试验n地点：2000年至2004年在美国农村地区n参与者：45岁以上的现任和现任核武器工作人员，包括烟民和从不吸烟者，暴露于不同的环境n干预措施：总共对4,401名参与者进行了CT扫描以进行肺癌的CT扫描，首先进行了最有效的低剂量CT扫描，在3、6和12个月的间隔CT扫描中发现了不确定的肺结节（例如，并非立即可疑的结节）结果：我们对807名参与者中的95％以上的患者进行了至少18个月的随访，随访时间至少为18个月。不能确定或可疑的肺结节。在随后的18个月中，仅727个不确定结节中有3个被确定为恶性。放射科医生指定为可疑结节的敏感性为84.2％，特异性为96.6％。假设肺癌的先验概率为2.4％，阳性和阴性的预测值分别为37.2％和99.6％。总体而言，共检测到33种原发性肺癌，包括19种I期癌症，5种II期癌症，7种III-IV期癌症和3种有限期小细胞癌。n结论：螺旋CT扫描可检测到许多不确定的结节，但恶性n CT扫描很少检测早期肺癌的高灵敏度和特异性。螺旋CT扫描的假阳性结果的问题是有限的，可以合理地解决。支持当前的CTn后续建议。 （CHEST 2007; 131：1028-1034）

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