2023 World Conference on Lung Cancer (Posters)-EP05.01. A Retrospective Audit of Lung Nodules with Validation of the Brock Tool in a Singaporean Cohort

EP05.01. A Retrospective Audit of Lung Nodules with Validation of the Brock Tool in a Singaporean Cohort - PDF(Slides)

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A recent study conducted in Singapore aimed to validate the use of the Brock Tool, a risk prediction algorithm, in the management of lung nodules. Lung nodule management is challenging in Asia due to the higher incidence of tuberculosis and lung cancer in never smokers. Currently, there are no evidence-based Asian guidelines for the management of lung nodules, leading to variable practices among physicians. <br /><br />The study involved a retrospective audit of 170 individuals with lung nodules, and the Brock scores were computed for 163 cases with single or multiple pulmonary nodules. The analysis revealed that larger nodule size, spiculation, pleural/perifissural retraction, and emphysema were characteristics associated with malignancy. No malignancy was detected in nodules smaller than 5mm, patients younger than 50 years old, or in calcified nodules.<br /><br />The study found that the Brock tool performed well in the Singaporean cohort, with a sensitivity of 60.0%, specificity of 80.4%, positive predictive value of 30.0%, and negative predictive value of 93.5% at a threshold of 10%. The area under the receiver operating curve (AUROC) was 0.76.<br /><br />The authors of the study concluded that international guidelines for pulmonary nodules are applicable in Singapore. They also suggested that nodules in younger patients, nodules smaller than 5mm, and calcified nodules may not require follow-up. Despite some missing data and clinician-derived calculations, the Brock tool showed good performance in the cohort.<br /><br />This study highlights the importance of standardized guidelines for the management of lung nodules in Asia. The validation of the Brock Tool in the Singaporean cohort provides evidence for its effectiveness in predicting malignancy in indeterminate pulmonary nodules. Further research and validation in larger populations are needed to establish its applicability in other Asian countries.

Asset Subtitle

Mamta Ruparel

Meta Tag

Speaker Mamta Ruparel

Topic Pulmonology & Staging

Keywords

Singapore

Brock Tool

lung nodules

Asia

malignancy

nodule size

spiculation

calcified nodules

international guidelines

validation