2022 World Conference on Lung Cancer (ePosters)-EP01.05-011. Radiologic Features of Nodules Attached to the Mediastinal or Diaphragmatic Pleura

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This study aimed to determine whether pulmonary noncalcified nodules (NCNs) attached to the mediastinal or diaphragmatic pleura (MP-NCNs or DP-NCNs) with specific characteristics should follow the same recommendations as costal pleural NCNs in terms of annual screening. The study involved a total of 1,451 lung cancer patients from two large cohorts and the CT scans were reviewed by four radiologists.<br /><br />The results showed that among the MP-NCN lung cancers, almost half had an average diameter between 15.0 mm and 30.0 mm, had a non-smooth margin, irregular shape, and a broad pleural attachment. On the other hand, among the DP-NCN lung cancers, more than half had an average diameter between 15.0 mm and 30.0 mm, had an irregular shape, and a broad pleural attachment. Emphysema was seen near some MP-NCNs and DP-NCNs, and on pathology, adenocarcinoma was the most common type of cancer for both groups.<br /><br />Importantly, none of the MP-NCNs or DP-NCNs with solid lung cancers had a smooth margin or triangular or lentiform, oval, semi-circular (LOS) shape, which is the typical criteria for recommending follow-up imaging on the next annual screening rather than immediate workup.<br /><br />Based on these findings, the researchers recommend that MP-NCNs or DP-NCNs less than 10 mm in size with non-smooth margins and irregular shapes should still undergo follow-up on the next annual screening instead of immediate workup.<br /><br />In conclusion, this study found that MP-NCNs and DP-NCNs with specific characteristics should follow the same recommendations as costal pleural NCNs in terms of annual screening. These findings can inform clinical decision-making for the management of nodules attached to the mediastinal or diaphragmatic pleura during lung cancer screening.

Asset Subtitle

Yeqing Zhu

Meta Tag

Speaker Yeqing Zhu

Topic Early Detection and Screening - Pulmonary Nodule

Keywords

pulmonary noncalcified nodules

mediastinal pleura

diaphragmatic pleura

costal pleural nodules

annual screening

lung cancer patients

CT scans

radiologists

emphysema

adenocarcinoma