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Arnold CW, Wallace WD, Chen S, Oh A, Abtin F, Genshaft S, Binder S, Aberle D, Enzmann D. RadPath: A web-based system for integrating and correlating radiology and pathology findings during cancer diagnosis. Acad Radiol 2016 Jan;23(1):90-100 http://escholarship.org/uc/item/22x4021q Hravnak M, Chen L, Dubrawski A, Bose E, Clermont G, Pinsky MR. Real alerts and artifact classification in archived multi-signal vital sign monitoring data: implications for mining big data. J Clin Monit Comput 2016 Dec;30(6):875-88 https://link.springer.com/article/10.1007%2Fs10877-015-9788-2 Kalpathy-Cramer J, Zhao B, Goldgof D, Gu Y, Wang X, Yang H, Tan Y, Gillies R, Napel S. A comparison of lung nodule segmentation algorithms: methods and results from a multi-institutional study. J Digit Imaging 2016 Aug;29(4):476-87 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4942386/ Moss TJ, Lake DE, Calland JF, Enfield KB, Delos JB, Fairchild KD, Moorman JR. Signatures of subacute potentially catastrophic illness in the ICU: model development and validation. Crit Care Med 2016 Sep;44(9):1639-48 https://insights.ovid.com/pubmed?pmid=27452809 Petousis P, Han SX, Aberle D, Bui AA. Prediction of lung cancer incidence on the low-dose computed tomography arm of the National Lung Screening Trial: A dynamic Bayesian network. Artif Intell Med 2016 Sep;72:42-55 https://linkinghub.elsevier.com/retrieve/pii/S0933-3657(16)30106-3 Springer DB, Tarassenko L, Clifford GD. Logistic regression-HSMM-based heart sound segmentation. IEEE Trans Biomed Eng 2016 Apr;63(4):822-32 http://ieeexplore.ieee.org/document/7234876/

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Prediction of lung cancer incidence on the low-dose computed tomography arm of the National Lung Screening Trial: A dynamic Bayesian network

Artificial Intelligence in Medicine ◽

10.1016/j.artmed.2016.07.001 ◽

2016 ◽

Vol 72 ◽

pp. 42-55 ◽

Cited By ~ 23

Author(s):

Panayiotis Petousis ◽

Simon X. Han ◽

Denise Aberle ◽

Alex A.T. Bui

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Cancer Incidence ◽

Low Dose ◽

Dynamic Bayesian Network ◽

Lung Cancer Incidence ◽

National Lung Screening Trial ◽

Low Dose Computed Tomography ◽

Lung Screening ◽

Screening Trial

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Incidental renal tumours on low-dose CT lung cancer screening exams

Journal of Medical Screening ◽

10.1177/0969141316657115 ◽

2016 ◽

Vol 24 (2) ◽

pp. 104-109 ◽

Cited By ~ 2

Author(s):

Paul F Pinsky ◽

Barbara Dunn ◽

David Gierada ◽

P Hrudaya Nath ◽

Reginald Munden ◽

...

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Renal Cancer ◽

Low Dose ◽

Lung Cancer Screening ◽

National Lung Screening Trial ◽

Renal Tumours ◽

Chest X Ray ◽

Low Dose Computed Tomography ◽

Lung Screening

Introduction Renal cancer incidence has increased markedly in the United States in recent decades, largely due to incidentally detected tumours from computed tomography imaging. Here, we analyze the potential for low-dose computed tomography lung cancer screening to detect renal cancer. Methods The National Lung Screening Trial randomized subjects to three annual screens with either low-dose computed tomography or chest X-ray. Eligibility criteria included 30 + pack-years, current smoking or quit within 15 years, and age 55–74. Subjects were followed for seven years. Low-dose computed tomography screening forms collected information on lung cancer and non-lung cancer abnormalities, including abnormalities below the diaphragm. A reader study was performed on a sample of National Lung Screening Trial low-dose computed tomography images assessing presence of abnormalities below the diaphragms and abnormalities suspicious for renal cancer. Results There were 26,722 and 26,732 subjects enrolled in the low-dose computed tomography and chest X-ray arms, respectively, and there were 104 and 85 renal cancer cases diagnosed, respectively (relative risk = 1.22, 95% CI: 0.9–1.5). From 75,126 low-dose computed tomography screens, there were 46 renal cancer diagnoses within one year. Abnormalities below the diaphragm rates were 39.1% in screens with renal cancer versus 4.1% in screens without (P < 0.001). Cases with abnormalities below the diaphragms had shorter median time to diagnosis than those without (71 vs. 160 days, P = 0.004). In the reader study, 64% of renal cancer cases versus 13% of non-cases had abnormalities below the diaphragms; 55% of cases and 0.8% of non-cases had a finding suspicious for renal cancer (P < 0.001). Conclusion Low-dose computed tomography screens can potentially detect renal cancers. The benefits to harms tradeoff of incidental detection of renal tumours on low-dose computed tomography is unknown.

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Lung Cancer Screening With Low Dose Computed Tomography in Patients With and Without Prior History of Cancer in the National Lung Screening Trial

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2021.02.003 ◽

2021 ◽

Author(s):

Louise M. Henderson ◽

Danielle D. Durham ◽

Martin C. Tammemägi ◽

Thad Benefield ◽

Mary W. Marsh ◽

...

Keyword(s):

Computed Tomography ◽

Low Dose ◽

Lung Cancer Screening ◽

Prior History ◽

National Lung Screening Trial ◽

History Of ◽

Low Dose Computed Tomography ◽

Lung Screening ◽

Screening Trial ◽

History Of Cancer

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False-positive screens and lung cancer risk in the National Lung Screening Trial: Implications for shared decision-making

Journal of Medical Screening ◽

10.1177/0969141317727771 ◽

2017 ◽

Vol 25 (2) ◽

pp. 110-112 ◽

Cited By ~ 19

Author(s):

Paul F Pinsky ◽

Christina R Bellinger ◽

David P Miller

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Cancer Risk ◽

False Positive ◽

Low Dose ◽

Lung Cancer Risk ◽

National Lung Screening Trial ◽

Low Dose Computed Tomography ◽

Lung Screening ◽

Screening Trial

Objectives Low-dose computed tomography lung cancer screening has been shown to reduce lung cancer mortality but has a high false-positive rate. The precision medicine approach to low-dose computed tomography screening assesses subjects’ benefits versus harms based on their personal lung cancer risk, where harms include false-positive screens and resultant invasive procedures. We assess the relationship between lung cancer risk and the rate of false-positive LDCT screens. Methods The National Lung Screening Trial randomized high-risk subjects to three annual screens with low-dose computed tomography or chest radiographs. Following the completion of National Lung Screening Trial, the Lung CT Screening Reporting and Data System (Lung-RADS) classification system was developed and retrospectively applied to National Lung Screening Trial low-dose computed tomography findings. The rate of false-positive screens (by Lung-RADS) and the resultant invasive procedures were examined as a function of lung cancer risk estimated by a model. Results Of 26,722 subjects randomized to the low-dose computed tomography arm, 26,309 received a baseline screen and were included in the analysis. The proportion with any false positive over three screening rounds increased from 12.9% to 25.9% from lowest to highest risk decile, and the proportion with an invasive procedure following a false positive also significantly increased from 0.7% to 2.0% from lowest to highest risk decile. Conclusion These findings indicate a need for personalized low-dose computed tomography lung cancer screening decision aids to accurately convey the benefits to harm trade-off.

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Medical Care Costs were Similar Across the Low-Dose Computed Tomography and Chest X-ray Arms of the National Lung Screening Trial (NLST) Despite Different Rates of Significant Incidental Findings

Medical Care ◽

10.1097/mlr.0000000000000900 ◽

2018 ◽

pp. 1 ◽

Cited By ~ 2

Author(s):

Ilana F. Gareen ◽

William C. Black ◽

Tor D. Tosteson ◽

Qianfei Wang ◽

JoRean D. Sicks ◽

...

Keyword(s):

Incidental Findings ◽

Low Dose ◽

X Ray ◽

Medical Care Costs ◽

National Lung Screening Trial ◽

Chest X Ray ◽

Low Dose Computed Tomography ◽

Lung Screening ◽

Care Costs ◽

Screening Trial

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Accuracy of Models to Identify Lung Nodule Cancer Risk in the National Lung Screening Trial

American Journal of Respiratory and Critical Care Medicine ◽

10.1164/rccm.201708-1632le ◽

2018 ◽

Vol 197 (9) ◽

pp. 1220-1223 ◽

Cited By ~ 11

Author(s):

Viswam S. Nair ◽

Vandana Sundaram ◽

Manisha Desai ◽

Michael K. Gould

Keyword(s):

Cancer Risk ◽

Lung Nodule ◽

National Lung Screening Trial ◽

Lung Screening ◽

Screening Trial

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Lung Cancer Screening

South African Respiratory Journal ◽

10.7196/sarj.2015.v21i4.37 ◽

2015 ◽

Vol 21 (4) ◽

pp. 101

Author(s):

Bronwyn Schar

Keyword(s):

Lung Cancer ◽

Lung Cancer Screening ◽

Mortality And Morbidity ◽

National Lung Screening Trial ◽

Incurable Disease ◽

Low Dose Computed Tomography ◽

Global And Local ◽

Lung Screening ◽

Asymptomatic Disease ◽

Related Mortality

Lung cancer (LC) is the leading cause of cancer-related death worldwide. Its overall poor prognosis is attributable to the fact that most patients remain asymptomatic until the disease is advanced and, therefore, present with late-stage incurable disease. e rationale for LC screening is that early detection of asymptomatic disease oers the opportunity for earlier intervention, at a stage when denitive cure is still feasible, which has the potential to reduce LC-related mortality and morbidity. e ndings of the National Lung Screening Trial provided the rst strong evidence in support of this rationale. Since its publication, several professional organisations and societies have developed guidelines recommending the implementation of LC screening with low-dose computed tomography in asymptomatic, high-risk individuals. Although the benets of such screening programmes may be signicant, they must be carefully weighed against the potential harms to the relatively large number of healthy individuals who would undergo screening. is review examines the available evidence and current recommendations for LC screening, including benets, potentials harms and requirements for implementation of a high-quality, safe and eective programme. In addition, the costs and availability of LC screening programmes in both the global and local settings are considered.

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Thyroid Incidentalomas in Association With Low-Dose Computed Tomography in the National Lung Screening Trial

American Journal of Epidemiology ◽

10.1093/aje/kwz219 ◽

2019 ◽

Vol 189 (1) ◽

pp. 27-33

Author(s):

Holli A Loomans-Kropp ◽

Barbara K Dunn ◽

Barnett S Kramer ◽

Paul Pinsky

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Incidental Findings ◽

Low Dose ◽

Screening Methods ◽

National Lung Screening Trial ◽

Increased Risk ◽

Low Dose Computed Tomography ◽

Lung Screening ◽

Screening Trial

Abstract Advances in cancer screening methods have opened avenues for incidental findings and cancer overdiagnosis. We performed a secondary analysis of the National Lung Screening Trial (enrollment from 2002–2004), a randomized controlled trial comparing low-dose computed tomography (LDCT; n = 26,722) with chest radiography (CXR; n = 26,732) for lung cancer detection, to examine incidental findings related to thyroid cancer (ThCa). Three screening rounds were included, and median follow-up was 6.6 years for LDCT and 6.5 years for CXR. Radiologists reported lung and non-lung-related abnormalities. In the LDCT arm, 5.7%, 4.7%, and 4.5% of participants had abnormalities above the diaphragm (AADs) detected at baseline, year 1, and year 2, respectively, compared with 2.3%, 1.5%, and 1.3% in the CXR arm. In the LDCT arm, 205 AADs (7.0%) were thyroid-related. Overall, 60 ThCas were reported, 35 in the LDCT arm and 25 in the CXR arm (P = 0.2). In the LDCT arm, participants with a prior AAD had a 7.8-fold increased risk (95% confidence interval: 4.0, 15.1) of ThCa compared with those who did not have an AAD. Early and persistent excess of ThCas diagnosed earlier in the LDCT arm suggests overdiagnosis. The use of sensitive screening modalities for early detection of lung cancer might result in the discovery of thyroid incidentalomas.

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