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MA01.10 Performance of ACR Lung-RADS in the 1st Brazilian Lung Cancer Screening Trial (BRELT1)
January 2017
proportion of Stage I (36% vs 6%, (p<0.0001) was observed in the active group. Conclusion: LDCT screening could reduce LC-specific and overall mortality. The number of Lung cancer diagnosed in the two groups did not suggest over-diagnosis, after 8.5 years of follow-up time. Keywords: efficacy, lung cancer, Screening, Overdiagnosis
Abstracts
S347
(5% or less). Among 26 patients who underwent biopsy in BRELT1, we found 12 cases of lung cancer, of which 90% were stage IA or IB. Conclusion: The application of ACR Lung-RADS and PTPM associated with careful multidisciplinary assessment can help in the decision process. The follow-up of patients with positive nodules requires careful analysis of the main factors related to malignancy. Keywords: Screening, lung cancer, nodules
MA01.10 Performance of ACR Lung-RADS in the 1st Brazilian Lung Cancer Screening Trial (BRELT1) Ricardo Santos,1 Juliana Franceschini,1 Mário Ghefter,1 Rodrigo Chate,1 André Luiz Trajano,1 Roberto Saad Junior2 1Hospital Israelita Albert Einstein, São Paulo/Brazil, 2Faculdade de Ciências Médicas Da Santa Casa de São Paulo, São Paulo/Brazil Background: In BRELT1 we found a significant number of low dose CT (LDCT) considered positive (nodules > 4mm). The aim of this study was to assess the effect of applying ACR Lung-RADS and Pre-Test Probability of Malignancy (PTPM) in suspicious nodules 8mm founded in a clinical CT lung screening program. Methods: Clinical LDCT (baseline and follow up) containing nodules 8mm were retroactively reclassified using the new ACR Lung-RADSTM structured reporting system and PTPM. The model used in this study to predict the probability of malignancy was designed by Swensen et al and included patient’s age, current or former smoker, diameter of the nodule, speculation and location. All LDCT had initially been interpreted by radiologists accredited in CT lung screening reporting following the National Comprehensive Cancer Network’s Clinical Practice Guidelines in Oncology: Lung Cancer Screening (version 1.2012), which considered as positive the same criteria from the National Lung Screening Trial. Results: In BRELT1 were recruited 790 current or former smokers, with a heavy smoking history. A total of 552 nodules were found in 312 positive LDCT at baseline (39%). LDCT follow up was performed in 89.1% of this population. From them 74 patients presented solid or semi solid nodules 8mm in the highest diameter. According to ACR Lung-RADSTM 39 baseline LDCT were classified as 4A (52.7%), 6 as 4B (8.1%), 17 as 4X (22.9%) and 10 as 2 (13.5%). Follow-up LDCT showed reduction in the category in more than 80% of cases. Using the PTPM, 44 cases were considered at moderate risk (between 6 and 60%) and 30 cases of high risk for malignancy (over 60%). None was considered low risk
MA01.11 Implementation of LDCT Lung Cancer Screening into Practice. Results of Regional Early Detection Program Maciej Bryl,1 Beata Nikisch,2 Wojciech Dyszkiewicz,3 Cezary Piwkowski,3 Mariusz Kasprzyk,3 Wojciech Kasprzak,4 Aleksander Barinow-Wojewodzki5 1Oddzial Onkologii, Wielkopolskie Centrum Pulmonologii I Torakochirurgii, Poznan/Poland, 2Zaklad Radiologii, Wielkopolskie Centrum Pulmonologii I Torakochirurgii, Poznan/Poland, 3 Oddzial Torakochirurgii, Wielkopolskie Centrum Pulmonologii I Torakochirurgii, Poznan/Poland, 4Oddzial Pulmonologiczno-Internistyczny, Wielkopolskie Centrum Pulmonologii I Torakochirurgii, Poznan/Poland, 5Oddzial Pulmonologiczno-Rehabilitacyjny, Wielkopolskie Centrum Pulmonologii I Torakochirurgii, Poznan/Poland Background: Lung cancer is the leading cause of cancer deaths both in men and women in either Wielkopolska and the whole Poland. Wielkopolska is one of Polish regions (voivodships) with about 3,4 mln inhabitants and incidence of lung cancer approx. 1900 new cases every year. Screening by low dose computer tomography (LDCT) showed reduction of lung cancer mortality in NLST trial. Regional authorities covered this program from local budget beside Polish health system. Methods: Since October 2009 program of early detection of lung cancer started in 5 centers of Wielkopolska region. Till the end of 2015 N¼17222 subjects were screened. The entry criteria were: age between 55 and 70 years and smoking 20 pack/years. Every person has the LDCT performed. Results were first classified as normal or abnormal. Abnormalities were divided into 6 categories: <5mm single, <5 mm multiple, 5-15 mm single, 5-15 mm multiple, >15 mm single, >15 mm multiple. Patient received also recommendation for further actions. Results presented are based on annual reports for regional authorities. Results: More than 85% of the images were classified as abnormal. Nodes of any kind were found in about 47% of
proportion of Stage I (36% vs 6%, (p<0.0001) was observed in the active group. Conclusion: LDCT screening could reduce LC-specific and overall mortality. The number of Lung cancer diagnosed in the two groups did not suggest over-diagnosis, after 8.5 years of follow-up time. Keywords: efficacy, lung cancer, Screening, Overdiagnosis
Abstracts
S347
(5% or less). Among 26 patients who underwent biopsy in BRELT1, we found 12 cases of lung cancer, of which 90% were stage IA or IB. Conclusion: The application of ACR Lung-RADS and PTPM associated with careful multidisciplinary assessment can help in the decision process. The follow-up of patients with positive nodules requires careful analysis of the main factors related to malignancy. Keywords: Screening, lung cancer, nodules
MA01.10 Performance of ACR Lung-RADS in the 1st Brazilian Lung Cancer Screening Trial (BRELT1) Ricardo Santos,1 Juliana Franceschini,1 Mário Ghefter,1 Rodrigo Chate,1 André Luiz Trajano,1 Roberto Saad Junior2 1Hospital Israelita Albert Einstein, São Paulo/Brazil, 2Faculdade de Ciências Médicas Da Santa Casa de São Paulo, São Paulo/Brazil Background: In BRELT1 we found a significant number of low dose CT (LDCT) considered positive (nodules > 4mm). The aim of this study was to assess the effect of applying ACR Lung-RADS and Pre-Test Probability of Malignancy (PTPM) in suspicious nodules 8mm founded in a clinical CT lung screening program. Methods: Clinical LDCT (baseline and follow up) containing nodules 8mm were retroactively reclassified using the new ACR Lung-RADSTM structured reporting system and PTPM. The model used in this study to predict the probability of malignancy was designed by Swensen et al and included patient’s age, current or former smoker, diameter of the nodule, speculation and location. All LDCT had initially been interpreted by radiologists accredited in CT lung screening reporting following the National Comprehensive Cancer Network’s Clinical Practice Guidelines in Oncology: Lung Cancer Screening (version 1.2012), which considered as positive the same criteria from the National Lung Screening Trial. Results: In BRELT1 were recruited 790 current or former smokers, with a heavy smoking history. A total of 552 nodules were found in 312 positive LDCT at baseline (39%). LDCT follow up was performed in 89.1% of this population. From them 74 patients presented solid or semi solid nodules 8mm in the highest diameter. According to ACR Lung-RADSTM 39 baseline LDCT were classified as 4A (52.7%), 6 as 4B (8.1%), 17 as 4X (22.9%) and 10 as 2 (13.5%). Follow-up LDCT showed reduction in the category in more than 80% of cases. Using the PTPM, 44 cases were considered at moderate risk (between 6 and 60%) and 30 cases of high risk for malignancy (over 60%). None was considered low risk
MA01.11 Implementation of LDCT Lung Cancer Screening into Practice. Results of Regional Early Detection Program Maciej Bryl,1 Beata Nikisch,2 Wojciech Dyszkiewicz,3 Cezary Piwkowski,3 Mariusz Kasprzyk,3 Wojciech Kasprzak,4 Aleksander Barinow-Wojewodzki5 1Oddzial Onkologii, Wielkopolskie Centrum Pulmonologii I Torakochirurgii, Poznan/Poland, 2Zaklad Radiologii, Wielkopolskie Centrum Pulmonologii I Torakochirurgii, Poznan/Poland, 3 Oddzial Torakochirurgii, Wielkopolskie Centrum Pulmonologii I Torakochirurgii, Poznan/Poland, 4Oddzial Pulmonologiczno-Internistyczny, Wielkopolskie Centrum Pulmonologii I Torakochirurgii, Poznan/Poland, 5Oddzial Pulmonologiczno-Rehabilitacyjny, Wielkopolskie Centrum Pulmonologii I Torakochirurgii, Poznan/Poland Background: Lung cancer is the leading cause of cancer deaths both in men and women in either Wielkopolska and the whole Poland. Wielkopolska is one of Polish regions (voivodships) with about 3,4 mln inhabitants and incidence of lung cancer approx. 1900 new cases every year. Screening by low dose computer tomography (LDCT) showed reduction of lung cancer mortality in NLST trial. Regional authorities covered this program from local budget beside Polish health system. Methods: Since October 2009 program of early detection of lung cancer started in 5 centers of Wielkopolska region. Till the end of 2015 N¼17222 subjects were screened. The entry criteria were: age between 55 and 70 years and smoking 20 pack/years. Every person has the LDCT performed. Results were first classified as normal or abnormal. Abnormalities were divided into 6 categories: <5mm single, <5 mm multiple, 5-15 mm single, 5-15 mm multiple, >15 mm single, >15 mm multiple. Patient received also recommendation for further actions. Results presented are based on annual reports for regional authorities. Results: More than 85% of the images were classified as abnormal. Nodes of any kind were found in about 47% of