title: Towards a close computed tomography monitoring approach for screen detected subsolid pulmonary nodules?
abstract: Pulmonary subsolid nodules (SSNs) have a high likelihood of malignancy, but are often indolent. A conservative treatment approach may therefore be suitable. The aim of the current study was to evaluate whether close follow-up of SSNs with computed tomography may be a safe approach. The study population consisted of participants of the Dutch-Belgian lung cancer screening trial (Nederlands Leuvens Longkanker Screenings Onderzoek; NELSON). All SSNs detected during the trial were included in this analysis. Retrospectively, all persistent SSNs and SSNs that were resected after first detection were segmented using dedicated software, and maximum diameter, volume and mass were measured. Mass doubling time (MDT) was calculated. In total 7135 volunteers were included in the current analysis. 264 (3.3%) SSNs in 234 participants were detected during the trial. 147 (63%) of these SSNs in 126 participants disappeared at follow-up, leaving 117 persistent or directly resected SSNs in 108 (1.5%) participants available for analysis. The median follow-up time was 95 months (range 20-110 months). 33 (28%) SSNs were resected and 28 of those were (pre-) invasive. None of the non-resected SSNs progressed into a clinically relevant malignancy. Persistent SSNs rarely developed into clinically manifest malignancies unexpectedly. Close follow-up with computed tomography may be a safe option to monitor changes.
authors.affiliation: Dept of Radiology, University Medical Center, Utrecht, The Netherlands Dept of Radiology, Kennemer Gasthuis, Haarlem, The Netherlands.
authors.forename: Ernst T
authors.initials: ET
authors.lastname: Scholten
authors.affiliation: Dept of Radiology, University Medical Center, Utrecht, The Netherlands P.deJong-8@umcutrecht.nl.
authors.forename: Pim A
authors.initials: PA
authors.lastname: de Jong
authors.affiliation: Dept of Radiology, University Medical Center, Utrecht, The Netherlands.
authors.forename: Bartjan
authors.initials: B
authors.lastname: de Hoop
authors.affiliation: Dept of Pulmonology, Lievensberg Hospital, Bergen op Zoom, The Netherlands.
authors.forename: Rob
authors.initials: R
authors.lastname: van Klaveren
authors.affiliation: Dept of Radiology, University Medical Center, Utrecht, The Netherlands.
authors.forename: Saskia
authors.initials: S
authors.lastname: van Amelsvoort-van de Vorst
authors.affiliation: Center for Medical Imaging - North East Netherlands, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Matthijs
authors.initials: M
authors.lastname: Oudkerk
authors.affiliation: Dept of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Rozemarijn
authors.initials: R
authors.lastname: Vliegenthart
authors.affiliation: Dept of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Harry J
authors.initials: HJ
authors.lastname: de Koning
authors.affiliation: Dept of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands Dept of Pulmonology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Carlijn M
authors.initials: CM
authors.lastname: van der Aalst
authors.affiliation: Dept of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: René M
authors.initials: RM
authors.lastname: Vernhout
authors.affiliation: Dept of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Harry J M
authors.initials: HJ
authors.lastname: Groen
authors.affiliation: Dept of Pulmonology, University Medical Center, Utrecht, The Netherlands.
authors.forename: Jan-Willem J
authors.initials: JW
authors.lastname: Lammers
authors.affiliation: Diagnostic Image Analysis Group, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Bram
authors.initials: B
authors.lastname: van Ginneken
authors.affiliation: Diagnostic Image Analysis Group, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands Fraunhofer MEVIS, Bremen, Germany.
authors.forename: Colin
authors.initials: C
authors.lastname: Jacobs
authors.affiliation: Dept of Radiology, University Medical Center, Utrecht, The Netherlands.
authors.forename: Willem P T M
authors.initials: WP
authors.lastname: Mali
authors.affiliation: Dept of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands Dept of Pulmonology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Nanda
authors.initials: N
authors.lastname: Horeweg
authors.affiliation: Dept of Pulmonology, Kennemer Gasthuis, Haarlem, The Netherlands.
authors.forename: Carla
authors.initials: C
authors.lastname: Weenink
authors.affiliation: Dept of Pathology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Erik
authors.initials: E
authors.lastname: Thunnissen
authors.affiliation: Dept of Radiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Mathias
authors.initials: M
authors.lastname: Prokop
authors.affiliation: Dept of Radiology, University Medical Center, Utrecht, The Netherlands.
authors.forename: Hester A
authors.initials: HA
authors.lastname: Gietema
mesh_terms: D004210:Dissection / Q000379:methods; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008175:Lung Neoplasms / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods