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Shintaro Yoshida



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    P2.11 - Screening and Early Detection (ID 178)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Screening and Early Detection
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.11-43 - Management of Pulmonary Nodules Detected on CT: Multicenter Collaborative Study in Nagasaki Prefecture (ID 1774)

      10:15 - 18:15  |  Author(s): Shintaro Yoshida

      • Abstract
      • Slides

      Background

      Pulmonary nodules are frequently detected on low-dose CT screening of the chest. Most of them are benign and lung cancer is only a part, so handling of pulmonary nodules is a major issue. Although the guidelines of the Japanese Society of CT Screening have been published, the examination of their usefulness is not sufficient. Therefore, the pulmonary nodules detected on CT were handled according to the guideline (version 2), and the clinical significance and the usefulness of the guideline were examined.

      Method

      Pulmonary nodules with 5mm or larger in size on initial chest CT were followed up prospectively at five facilities in Nagasaki Prefecture. CT Images and clinical data were collected in one center, and analysis was performed on the same workstation (Aquarius Net Station ver. 1.5). In the central review, measurement at the workstation and evaluation of visual characteristics of the nodules were performed by two or more experienced radiologists, and the results were returned to the participating facilities to be reflected in the handling and follow-up of the nodules.

      Result

      131 cases were registered in total, 39 cases were excluded and the remaining 92 cases were analyzed (57 women, 35 men, average age 65.6 (39-87) years old). 39 cases were solid nodule, 17 cases were part solid ground-glass nodule (GGN) and 36 cases were pure GGN. 20 cases were surgically resected, and histological findings were obtained for 17 nodules: 14 adenocarciomas (two solid nodules, 7 part solid GGNs and 5 pure GGNs), two squamous cell carcinomas (two solid nodules), one lung metastasis (solid nodule). Fifteen cases shrank or disappeared overtime (7 solid nodules, 4 part solid GGNs and 4 pure GGNs). Twenty-four month follow-up was completed in 57 cases (27 solid nodules, 3 part solid GGNs and 27 pure GGNs).

      Conclusion

      Although handling of pulmonary nodules detected on chest CT was conventionally left to the discretion of the institution /in-charge doctor, using this guideline made the policy of clearer and became possible to evaluate the natural history of pulmonary nodules correctly. There were no cases that became inoperable due to the appearance of distant metastasis during follow-up, and this guideline was considered appropriate.

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