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Supplement: The Minimally Invasive Thoracic Surgery Summit

Computed Tomography Screening for Lung Cancer

Department of Radiology, The Mount Sinai Medical Center, New York, New York

^_* Address correspondence to Dr Wilck, The Mount Sinai Medical Center, Department of Radiology, Box 1234, One Gustave L. Levy Pl, New York, NY 10029-6574 (Email: eric.wilck@mssm.edu).

Presented at the Minimally Invasive Thoracic Surgery Summit, New York, NY, June 8–9, 2007.

The first 20% of the full text of this article appears below.

Lung cancer is the leading cause of cancer deaths in both men and women. In 2007, more than 200,000 new cases will be diagnosed in the United States. More individuals die of lung cancer than of colon, breast, and prostate cancer combined. In general, a lung cancer diagnosis imparts a poor prognosis, with 60% of patients dying within 1 year of diagnosis. Surgical resection of an early lung cancer, on the other hand, has a favorable prognosis. After resection of a stage 1A bronchogenic carcinoma, the patient has a 5-year survival of about 80% to 90%. With these thoughts in mind, large screening trials to detect early lung cancer have been undertaken.

The goal of a screening computed tomography (CT) of the chest is to detect a solitary pulmonary nodule in a patient at risk for lung cancer. Risk factors include smoking, environmental exposure, prior radiation, or family history. The risk of malignancy of a solitary pulmonary nodule also increases with age. Solitary pulmonary nodules are fairly common, and the incidence of malignancy depends upon the population under study.

The definition of a solitary pulmonary nodule is a relatively spherical opacity, 3 cm or less in diameter, surrounded by lung parenchyma. There should be no associated atelectasis or hilar lymphadenopathy. The probability of malignancy of a solitary lesion depends on both the appearance of the nodule and the clinical risk.

When a solitary pulmonary nodule is evaluated, there are certain features that favor a benign (Table 1) vs malignant cause (Table 2). Also, certain features of nodules correlate with . . . [Full Text of this Article]

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