Comparison of Lung-RADS Version 1.1 and Lung-RADS Version 2022 in Classifying Airway Nodules Detected at Lung Cancer Screening CT.
Comparison of Lung-RADS Version 1.1 and Lung-RADS Version 2022 in Classifying Airway Nodules Detected at Lung Cancer Screening CT.
复制标题
Lung-RADS 1.1 版和 Lung-RADS 2022 版在对肺癌筛查 CT 检测到的气道结节进行分类方面的比较。
DOI：
10.1148/ryct.230149
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Hammer,MarkM
中科院分区：
文献类型：
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作者：
DeSimone,AriadneK;Byrne,SuzanneC;Hammer,MarkM
目的比较肺部影像报告和数据系统（Lung-RADS）版本 1.1使用2022版肺部检测到的气道结节分类 材料与方法本回顾性研究包括所有接受肺活检的患者， 癌症筛查CT检查在作者的保健 2015年至2021年期间报告的气道或支气管内网络 结节。一位接受过奖学金培训的心胸放射科医生审查了这些 CT图像和特征的气道结节的大小，位置， 多样性、形态学、气道的依赖部分、内部空气， 液体衰减、远端变化、随访结局和最终 病理诊断，如果是恶性。敏感性和特异性 肺RADS 1.1版检测恶性结节与 结果共纳入174例患者。其中，163例（94%）有气道 结节被认为是良性的，而11（6%）有恶性结节。 气管和主支气管内的气道结节均为良性， 而肺叶和节段性气道结节发生肺损伤的风险最高， 癌症（分别为17.2%和11.1%）。12个亚段气道 阻塞性结节，3例（25%）为恶性，9例（75%） 是良性的依赖性非梗阻性结节 部分气道、内部空气或液体衰减均为良性。 92例肺RADS阳性患者中，仅10例（10.9%） 报告有癌症。Lung-RADS版本2022导致更高的特异性 与版本1.1相比（82% vs 50%，P < .001）， 结论与前一版本相比，Lung-RADS 2022版降低了肺动脉高压的发生率。 假阳性筛查CT检查的数量， 识别恶性气道结节。关键词：CT，肺，原发性肿瘤，肺，肺 癌症筛查、肺RADS、呼吸道感染风险、气道感染、支气管内 联系我们© RSNA，2024
PurposeTo compare the Lung Imaging Reporting and Data System (Lung-RADS) version 1.1 with version 2022 classification of airway nodules detected at lung cancer screening CT examinations.Materials and MethodsThis retrospective study included all patients who underwent a lung cancer screening CT examination in the authors’ health care network between 2015 and 2021 with a reported airway or endobronchial nodule. A fellowship-trained cardiothoracic radiologist reviewed these CT images and characterized the airway nodules by size, location, multiplicity, morphology, dependent portions of airway, internal air, fluid attenuation, distal changes, outcome at follow-up, and final pathologic diagnosis, if malignant. Sensitivity and specificity of Lung-RADS version 1.1 in detecting malignant nodules were compared with those of Lung-RADS version 2022 using the McNemar test.ResultsA total of 174 patients were included. Of these, 163 (94%) had airway nodules that were deemed benign, while 11 (6%) had malignant nodules. Airway nodules in the trachea and mainstem bronchi were all benign, while lobar and segmental airway nodules had the highest risk for lung cancer (17.2% and 11.1%, respectively). Of the 12 subsegmental airway nodules that were obstructive, three (25%) were malignant and nine (75%) were benign. Nodules with nonobstructive morphologies, dependent portions of airway, internal air, or fluid attenuation were all benign. Only 10 of the 92 (10.9%) patients with positive Lung-RADS by clinical report had cancer. Lung-RADS version 2022 resulted in higher specificity than version 1.1 (82% vs 50%,P< .001), without sacrificing sensitivity (91% for both).ConclusionCompared with the previous version, Lung-RADS version 2022 reduced the number of false-positive screening CT examinations while still identifying malignant airway nodules.Keywords:CT, Lung, Primary Neoplasms, Pulmonary, Lung Cancer Screening, Lung-RADS, Nodule Risk, Airway Nodule, Endobronchial Nodule© RSNA, 2024