ArticleKorean journal of radiology2026
Missed Incidental Lung Cancer on Neck CT: Determinants and Impact on Diagnostic Delay and Stage Shift.
Article in Korean journal of radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo assess the determinants and clinical impact of missed incidental lung cancers on neck CT and explore the potential role of artificial intelligence-based computer-aided detection (AI-CAD). MATERIALS AND
methodsThis study retrospectively screened adults who underwent neck CT at a tertiary care hospital between 2008 and 2024. Patients with prior lung cancer, prior or concurrent chest CT, absence of visible lung lesions on neck CT, lack of histological confirmation, or indeterminate staging or stage shift were excluded. Determinants of missed detection and their impact on diagnostic intervals and stage shift (progression in any T, N, or M category) were evaluated. AI-CAD was retrospectively applied to the missed cases.
resultsOf 81,794 patients screened, 123 with lung cancer visible on neck CT were identified (mean age, 65.1 ± 10.5 years; 63 male), of whom 80 (65.0%) were not described in the original reports. Missed detection was more common with CT examinations including CT angiography (odds ratio [OR], 3.40 [95% confidence interval {CI}: 1.13, 11.69];
conclusionIncidental lung cancers on neck CT are rare but are frequently overlooked. Missed detection is associated with substantially longer diagnostic intervals and more frequent stage shifts. AI-CAD has the potential to reduce diagnostic oversight, warranting further validation.
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