title: From diagnosis to therapy in lung cancer: management of CT detected pulmonary nodules, a summary of the 2015 Chinese-German Lung Cancer Expert Panel.
abstract: The first Chinese-German Lung Cancer Expert Panel was held in November 2015 one day after the 7th Chinese-German Lung Cancer Forum, Shanghai. The intention of the meeting was to discuss strategies for the diagnosis and treatment of lung cancer within the context of lung cancer screening. Improved risk classification criteria and novel imaging approaches for screening populations are highly required as more than half of lung cancer cases are false positive during the initial screening round if the National Lung Screening Trial (NLST) demographic criteria [≥30 pack years (PY) of cigarettes, age ≥55 years] are applied. Moreover, if the NLST criteria are applied to the Chinese population a high number of lung cancer patients are not diagnosed due to non-smoking related risk factors in China. The primary goal in the evaluation of pulmonary nodules (PN) is to determine whether they are malignant or benign. Volumetric based screening concepts such as investigated in the Dutch-Belgian randomized lung cancer screening trial (NELSON) seem to achieve higher specificity. Chest CT is the best imaging technique to identify the origin and location of the nodule since 20% of suspected PN found on chest X-ray turn out to be non-pulmonary lesions. Moreover, novel state-of-the-art CT systems can reduce the radiation dose for lung cancer screening acquisitions down to a level of 0.1 mSv with improved image quality to novel reconstruction techniques and thus reduce concerns related to chest CT as the primary screening technology. The aim of the first part of this manuscript was to summarize the current status of novel diagnostic techniques used for lung cancer screening and minimally invasive treatment techniques for progressive PNs that were discussed during the first Chinese-German Lung Cancer. This part should serve as an educational part for the readership of the techniques that were discussed during the Expert Panel. The second part summarizes the consensus recommendations that were interdisciplinary discussed by the Expert Panel.
authors.affiliation: Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200090, China ;
authors.forename: Chunxia
authors.initials: C
authors.lastname: Su
authors.affiliation: Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany ;
authors.forename: Mathias
authors.initials: M
authors.lastname: Meyer
authors.affiliation: Department of Medicine, Medical University of Vienna, Vienna, Austria ;
authors.forename: Robert
authors.initials: R
authors.lastname: Pirker
authors.affiliation: Medical Innovation and Management, Steinbeis University Berlin, Germany ;
authors.forename: Wieland
authors.initials: W
authors.lastname: Voigt
authors.affiliation: Radiology Department, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200090, China.
authors.forename: Jingyun
authors.initials: J
authors.lastname: Shi
authors.affiliation: Division of Thoracic Oncology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany ;
authors.forename: Lothar
authors.initials: L
authors.lastname: Pilz
authors.affiliation: Division of Respiratory Medicine and Thoracic Oncology, Ludwig-Maximilians-University of Munich Thoracic Oncology Centre, Munich, Germany ;
authors.forename: Rudolf M
authors.initials: RM
authors.lastname: Huber
authors.affiliation: Guangdong General Hospital, Lung Cancer Institute, Guangzhou 510080, China ;
authors.forename: Yilong
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China ;
authors.forename: Jinghong
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Radiology, Beijing Union Medical College Hospital, Beijing 100730, China ;
authors.forename: Yonglan
authors.initials: Y
authors.lastname: He
authors.affiliation: Department of Radiology, Beijing Union Medical College Hospital, Beijing 100730, China ;
authors.forename: Xuan
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Respiratory, the Fourth Military Medical University Xijing Hospital, Xi'an 710032, China ;
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China ;
authors.forename: Xiuyi
authors.initials: X
authors.lastname: Zhi
authors.affiliation: Department of Oncology, Tumor Hospital of Jiangsu Province, Nanjing 210000, China ;
authors.forename: Meiqi
authors.initials: M
authors.lastname: Shi
authors.affiliation: Department of Oncology, Xinqiao Hospital of Third Military Medical University, Chongqing 400037, China ;
authors.forename: Bo
authors.initials: B
authors.lastname: Zhu
authors.affiliation: Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany ;
authors.forename: Stefan S
authors.initials: SS
authors.lastname: Schoenberg
authors.affiliation: Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany ;
authors.forename: Thomas
authors.initials: T
authors.lastname: Henzler
authors.affiliation: Division of Thoracic Oncology, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Manegold
authors.affiliation: Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200090, China ;
authors.forename: Caicun
authors.initials: C
authors.lastname: Zhou
authors.affiliation: Division of Surgical Oncology and Thoracic Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors.forename: Eric Dominic
authors.initials: ED
authors.lastname: Roessner
keywords: Lung cancer; modern imaging; molecular markers; pulmonary nodules (PN); response assessment; screening, minimally-invasive therapy