title: CT Screening for Lung Cancer: Part-Solid Nodules in Baseline and Annual Repeat Rounds.
abstract: OBJECTIVE
  The purpose of this study was to assess the frequencies of identifying participants with part-solid nodules, of diagnostic pursuit, of diagnoses of lung cancer, and long-term lung cancer survival in baseline and annual repeat rounds of CT screening in the International Early Lung Cancer Action Project.
  
  
  METHODS
  Screenings were performed under a common protocol. Participants with solid, nonsolid, and part-solid nodules and the diagnoses of lung cancer were documented.
  
  
  RESULTS
  Part-solid nodules were identified in 2892 of 57,496 (5.0%) baseline screening studies; 567 (19.6%) of these nodules resolved or decreased in size. Diagnostic pursuit led to the diagnosis of adenocarcinoma in 79 cases, all clinical stage I. At resection, one nodule (12-mm solid component) had a single N2 metastasis. A new part-solid nodule was identified in 541 of 64,677 (0.8%) annual repeat screenings; 377 (69.7%) of these nodules resolved or decreased in size. In eight cases among the 541, the diagnosis of adenocarcinoma manifesting as a part solid nodule was made; on retrospective review the nodule originally had been a nonsolid nodule. In another 20 cases, the cancer originally had manifested as a nonsolid nodule but had progressed to become part-solid at annual repeat screening before any diagnosis was pursued. These 28 annual repeat cases of lung cancer were all pathologic stage IA. Of the 107 cases of lung cancer (79 baseline cases and 28 annual repeat cases), 106 were surgically resected, and one baseline case was followed up with imaging for 4 years. The lung cancer survival rate was 100% with a median follow-up period from diagnosis of 89 months (interquartile range, 52-134 months).
  
  
  CONCLUSIONS
  Lung cancers manifesting as part-solid nodules at repeat screening studies all started as nonsolid nodules. Among 107 cases of adenocarcinoma manifesting as a part-solid nodule, a single lymph node metastasis was found in a single case (solid component, 12 mm).
authors.affiliation: 1 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Pl, New York, NY 10029.
authors.forename: Claudia I
authors.initials: CI
authors.lastname: Henschke
authors.affiliation: 1 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Pl, New York, NY 10029.
authors.forename: Rowena
authors.initials: R
authors.lastname: Yip
authors.affiliation: 2 Department of Medicine, Weill Cornell Medical College, New York, NY.
authors.forename: James P
authors.initials: JP
authors.lastname: Smith
authors.affiliation: 3 Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Wolf
authors.affiliation: 3 Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Raja M
authors.initials: RM
authors.lastname: Flores
authors.affiliation: 1 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Pl, New York, NY 10029.|4 Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
authors.forename: Mingzhu
authors.initials: M
authors.lastname: Liang
authors.affiliation: 1 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Pl, New York, NY 10029.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Salvatore
authors.affiliation: 1 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Pl, New York, NY 10029.|4 Department of Radiology, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.affiliation: 1 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Pl, New York, NY 10029.
authors.forename: Dong Ming
authors.initials: DM
authors.lastname: Xu
authors.affiliation: 1 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Pl, New York, NY 10029.
authors.forename: David F
authors.initials: DF
authors.lastname: Yankelevitz
mesh_terms: D000368:Aged; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000401:mortality*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
keywords: CT screening; ground-glass nodules; lung cancer–specific survival; lung neoplasm; opacities