2026 IASLC CT Screening and Early Detection Symposium- - Moderator: Case Reviews and Audience Engagement

Pdf Summary

This case review presented 12 lung imaging scenarios to highlight the wide spectrum of early lung cancer appearances and common diagnostic pitfalls. The cases included former smokers, never-smokers, and patients with prior malignancy, infection, or chronic lung disease. Several lesions were subtle or atypical on CT, including ground-glass nodules, part-solid nodules, atypical cysts with wall thickening, tree-in-bud opacities, scar-associated lesions, and endobronchial abnormalities. Pathology across the cases demonstrated a range of lung cancers, most commonly adenocarcinoma but also squamous cell carcinoma, with stages varying from minimally invasive disease to nodal and distant spread.<br /><br />A recurring theme was the challenge of distinguishing cancer from benign processes such as infection, organizing pneumonia, post-surgical change, scar, or fungal disease. In some cases, PET-CT showed limited or misleading uptake, reinforcing that metabolic imaging alone cannot reliably exclude malignancy. Several patients underwent re-biopsy or surgery after interval growth or persistent suspicious imaging features, while others had lesions that resolved, confirming benign inflammatory disease.<br /><br />The panel questions focused on management decisions: when biopsy is necessary, when bronchoscopy should be recommended, how to interpret cystic wall thickening, whether to treat presumptively with antibiotics and follow-up, and whether special follow-up strategies are needed for nonsolid nodules in Asian nonsmoking women. There was also discussion of the strengths and limitations of AI in detecting central nodules near vessels.<br /><br />The take-home points were that early lung cancer can look very different and may mimic benign disease, so radiologists and multidisciplinary teams need a high index of suspicion. Careful follow-up and timely tissue diagnosis are essential, but overtreatment should be avoided.

Asset Subtitle

Suresh Senan

Meta Tag

Concept Advanced Lung Cancer

Concept Pulmonary Nodule

Concept Computed Tomography

Concept Atypical Pulmonary Lesion

Concept Part-Solid Nodule

Speaker Suresh Senan

Keywords

early lung cancer

lung imaging

ground-glass nodules

part-solid nodules

cystic wall thickening

tree-in-bud opacities

endobronchial lesions

PET-CT

biopsy follow-up

diagnostic pitfalls

Advanced Lung Cancer

Pulmonary Nodule

Computed Tomography

Atypical Pulmonary Lesion

Part-Solid Nodule

Suresh Senan