Performance of Lung-RADS in the National Lung Screening Trial: a retrospective assessment.
Performance of Lung-RADS in the National Lung Screening Trial: a retrospective assessment.
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DOI：
10.7326/m14-2086
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发表时间：
2015-04-07
影响因子：
39.2
通讯作者：
Kazerooni E
中科院分区：
文献类型：
--
作者：
Pinsky PF;Gierada DS;Black W;Munden R;Nath H;Aberle D;Kazerooni E
低剂量计算机断层扫描（LDCT）的肺癌筛查已被推荐，主要基于NLST（国家肺筛查试验）的结果。美国放射学会最近发布了Lung-RADS，这是一种用于LDCT肺癌筛查的分类系统。回顾性地将Lung-RADS标准应用于NLST。随机试验中一组的次要分析。33个美国筛查中心。参与者被随机分配到NLST的LDCT组，年龄在55至74岁之间，至少有30包年的吸烟史，并且是当前吸烟者或在过去15年内戒烟。每年进行3次LDCT肺癌筛查。LDCT筛查的肺RADS分类。肺RADS类别1至2构成阴性筛查结果，类别3至4构成阳性结果。在26722名LDCT组参与者中，26455人接受了基线筛查; 48671人在基线后进行了筛查。在基线时，假阳性结果率（1减去特异性率）为12.8%（95% CI，12.4%-13.2%）vs 26.6%（CI，26.1%至27.1%）;基线后，Lung-RADS的假阳性率为5.3%（CI，5.1%-5.5%），NLST为21.8%（CI，21.4%-22.2%）。Lung-RADS的基线敏感性为84.9%（CI，80.8%至89.0%），NLST为93.5%（CI，90.7%至96.3%），Lung-RADS基线后敏感性为78.6%（CI，74.6%至82.6%），NLST为93.8%（CI，91.4%至96.1%）。回顾性应用Lung-RADS标准。肺RADS可以显著降低假阳性结果率;然而，灵敏度也降低。在临床实践中使用肺RADS标准的效果必须仔细研究。国立卫生研究院。
Lung cancer screening with low-dose computed tomography (LDCT) has been recommended, based primarily on the results of the NLST (National Lung Screening Trial). The American College of Radiology recently released Lung-RADS, a classification system for LDCT lung cancer screening. To retrospectively apply the Lung-RADS criteria to the NLST. Secondary analysis of a group from a randomized trial. 33 U.S. screening centers. Participants were randomly assigned to the LDCT group of the NLST, were aged 55 to 74 years, had at least a 30–pack-year history of smoking, and were current smokers or had quit within the past 15 years. 3 annual LDCT lung cancer screenings. Lung-RADS classifications for LDCT screenings. Lung-RADS categories 1 to 2 constitute negative screening results, and categories 3 to 4 constitute positive results. Of 26 722 LDCT group participants, 26 455 received a baseline screening; 48 671 screenings were done after baseline. At baseline, the false-positive result rate (1 minus the specificity rate) for Lung-RADS was 12.8% (95% CI, 12.4% to 13.2%) versus 26.6% (CI, 26.1% to 27.1%) for the NLST; after baseline, the false-positive result rate was 5.3% (CI, 5.1% to 5.5%) for Lung-RADS versus 21.8% (CI, 21.4% to 22.2%) for the NLST. Baseline sensitivity was 84.9% (CI, 80.8% to 89.0%) for Lung-RADS versus 93.5% (CI, 90.7% to 96.3%) for the NLST, and sensitivity after baseline was 78.6% (CI, 74.6% to 82.6%) for Lung-RADS versus 93.8% (CI, 91.4% to 96.1%) for the NLST. Lung-RADS criteria were applied retrospectively. Lung-RADS may substantially reduce the false-positive result rate; however, sensitivity is also decreased. The effect of using Lung-RADS criteria in clinical practice must be carefully studied. National Institutes of Health.