ArticleEuropean radiology2021
Lung cancer screening by nodule volume in Lung-RADS v1.1: negative baseline CT yields potential for increased screening interval.
Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05766046 (Early Diagnosis of Lung Cancer of the Italian Pulmonary Screening Network), which is not on this map. Cited by 24 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Early Diagnosis of Lung Cancer of the Italian Pulmonary Screening Network (RISP): Comparative Analysis for the Use of Low Dose Computed Tomography and Promotion of Primary Prevention Interventions in Subjects at High Risk for Lung Cancer
Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Performance of Lung-RADS in different target populations: a systematic review and meta-analysis.European radiology · 2024Pooled it
- [China National Lung Cancer Screening Guideline with Low-dose Computed Tomography (2023 Version)].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2023Guideline
- Impact of low-dose computed tomography (LDCT) screening on lung cancer-related mortality.The Cochrane database of systematic reviews · 2022Pooled it
- Strategies for Reducing False-Positive Screening Results for Intermediate-Size Nodules Evaluated Using Lung-RADS: A Secondary Analysis of National Lung Screening Trial Data.AJR. American journal of roentgenology · 2022Trial
- Personalised screening intensity based on existing lung cancer risk and spirometry.ERJ open research · 2026Article
- RADS ALPHABET: news and tips for young and general radiologists.Insights into imaging · 2026Article
- The lung cancer screening marathon after baseline: evidence from incidence nodules.European radiology · 2025Article
- Nodule Characteristics, Clinical Risk Factors, and Radiologist Experience as Predictors of Positive Baseline LDCT Screening Results.Healthcare (Basel, Switzerland) · 2025Article
- Structured narrative review on lung cancer screening: current evidence, clinical practice implications and implementation insights from a multidisciplinary task force and patient representatives.European respiratory review : an official journal of the European Respiratory Society · 2025Review
- Recurrent medical imaging exposures for the care of patients: one way forward.European radiology · 2024Review
- Surveillance of subsolid nodules avoids unnecessary resections in lung cancer screening: long-term results of the prospective BioMILD trial.ERJ open research · 2024Article
- Construction of a risk screening and visualization system for pulmonary nodule in physical examination population based on feature self-recognition machine learning model.Frontiers in medicine · 2024Article
- Factors influencing the outcome of volumetry tools for pulmonary nodule analysis: a systematic review and attempted meta-analysis.Insights into imaging · 2023Review
- Article
- Radiation Exposure to Low-Dose Computed Tomography for Lung Cancer Screening: Should We Be Concerned?Tomography (Ann Arbor, Mich.) · 2023Review
- Diagnostic study on clinical feasibility of an AI-based diagnostic system as a second reader on mobile CT images: a preliminary result.Annals of translational medicine · 2022Article
- European lung cancer screening: valuable trial evidence for optimal practice implementation.The British journal of radiology · 2022Article
- Low-dose CT for lung cancer screening: position paper from the Italian college of thoracic radiology.La Radiologia medica · 2022Article
- Deep-learning reconstruction for ultra-low-dose lung CT: Volumetric measurement accuracy and reproducibility of artificial ground-glass nodules in a phantom study.The British journal of radiology · 2022Article
- Volumetric Measurements in Lung Cancer Screening Reduces Unnecessary Low-Dose Computed Tomography Scans: Results from a Single-Center Prospective Trial on 4119 Subjects.Diagnostics (Basel, Switzerland) · 2022Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
Abstract
objectivesThe 2019 Lung CT Screening Reporting & Data System version 1.1 (Lung-RADS v1.1) introduced volumetric categories for nodule management. The aims of this study were to report the distribution of Lung-RADS v1.1 volumetric categories and to analyse lung cancer (LC) outcomes within 3 years for exploring personalized algorithm for lung cancer screening (LCS).
methodsSubjects from the Multicentric Italian Lung Detection (MILD) trial were retrospectively selected by National Lung Screening Trial (NLST) criteria. Baseline characteristics included selected pre-test metrics and nodule characterization according to the volume-based categories of Lung-RADS v1.1. Nodule volume was obtained by segmentation with dedicated semi-automatic software. Primary outcome was diagnosis of LC, tested by univariate and multivariable models. Secondary outcome was stage of LC. Increased interval algorithms were simulated for testing rate of delayed diagnosis (RDD) and reduction of low-dose computed tomography (LDCT) burden.
resultsIn 1248 NLST-eligible subjects, LC frequency was 1.2% at 1 year, 1.8% at 2 years and 2.6% at 3 years. Nodule volume in Lung-RADS v1.1 was a strong predictor of LC: positive LDCT showed an odds ratio (OR) of 75.60 at 1 year (p < 0.0001), and indeterminate LDCT showed an OR of 9.16 at 2 years (p = 0.0068) and an OR of 6.35 at 3 years (p = 0.0042). In the first 2 years after negative LDCT, 100% of resected LC was stage I. The simulations of low-frequency screening showed a RDD of 13.6-21.9% and a potential reduction of LDCT burden of 25.5-41%.
conclusionsNodule volume by semi-automatic software allowed stratification of LC risk across Lung-RADS v1.1 categories. Personalized screening algorithm by increased interval seems feasible in 80% of NLST eligible. KEY POINTS: • Using semi-automatic segmentation of nodule volume, Lung-RADS v1.1 selected 10.8% of subjects with positive CT and 96.87 relative risk of lung cancer at 1 year, compared to negative CT. • Negative low-dose CT by Lung-RADS v1.1 was found in 80.6% of NLST eligible and yielded 40 times lower relative risk of lung cancer at 2 years, compared to positive low-dose CT; annual screening could be preference sensitive in this group. • Semi-automatic segmentation of nodule volume and increased screening interval by volumetric Lung-RADS v1.1 could retrospectively suggest a 25.5-41% reduction of LDCT burden, at the cost of 13.6-21.9% rate of delayed diagnosis.
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