Incidental Findings in Lung Cancer Screening.
Yenpo LinKhulan KhurelsukhI-Gung LiChen-Te WuYi-Ming WuGigin LinCheng-Hong TohYung Liang WanPublished in: Cancers (2024)
While low-dose computed tomography (LDCT) for lung cancer screening (LCS) has been recognized for its effectiveness in reducing lung cancer mortality, it often simultaneously leads to the detection of incidental findings (IFs) unrelated to the primary screening indication. These IFs present diagnostic and management challenges, potentially causing unnecessary anxiety and further invasive diagnostic procedures for patients. This review article provides an overview of IFs encountered in LDCT, emphasizing their clinical significance and recommended management strategies. We categorize IFs based on their anatomical locations (intrathoracic-intrapulmonary, intrathoracic-extrapulmonary, and extrathoracic) and discuss the most common findings. We highlight the importance of utilizing guidelines and standardized reporting systems by the American College of Radiology (ACR) to guide appropriate follow-ups. For each category, we present specific IF examples, their radiologic features, and the suggested management approach. This review aims to provide radiologists and clinicians with a comprehensive understanding of IFs in LCS for accurate assessment and management, ultimately enhancing patient care. Finally, we outline a few key aspects for future research and development in managing IFs.
Keyphrases
- computed tomography
- low dose
- randomized controlled trial
- end stage renal disease
- magnetic resonance imaging
- emergency department
- artificial intelligence
- newly diagnosed
- high dose
- magnetic resonance
- high resolution
- positron emission tomography
- peritoneal dialysis
- risk factors
- palliative care
- clinical practice
- deep learning
- sensitive detection