Snoeckx Annemiek, Silva Mario, Prosch Helmut, Biederer Jürgen, Frauenfelder Thomas, Gleeson Fergus, Jacobs Colin, Kauczor Hans-Ulrich, Parkar Anagha P, Schaefer-Prokop Cornelia, Prokop Mathias, Revel Marie-Pierre
Department of Radiology, Antwerp University Hospital, Edegem, Belgium.
Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
Eur Radiol. 2025 Jul 1. doi: 10.1007/s00330-025-11648-4.
Early detection of lung cancer through low-dose CT lung cancer screening in a high-risk population has proven to reduce lung cancer-specific mortality. Nodule management plays a pivotal role in early detection and further diagnostic approaches. The European Society of Thoracic Imaging (ESTI) has established a nodule management recommendation to improve the handling of pulmonary nodules detected during screening. For solid nodules, the primary method for assessing the likelihood of malignancy is to monitor nodule growth using volumetry software. For subsolid nodules, the aggressiveness is determined by measuring the solid part. The ESTI-recommendation enhances existing protocols but puts a stronger focus on lesion aggressiveness. The main goals are to minimise the overall number of follow-up examinations while preventing the risk of a major stage shift and reducing the risk of overtreatment. KEY POINTS: Question Assessment of nodule growth and management according to guidelines is essential in lung cancer screening. Findings Assessment of nodule aggressiveness defines follow-up in lung cancer screening. Clinical relevance The ESTI nodule management recommendation aims to reduce follow-up examinations while preventing major stage shift and overtreatment.
通过对高危人群进行低剂量CT肺癌筛查来早期发现肺癌，已被证明可降低肺癌特异性死亡率。结节管理在早期发现和进一步诊断方法中起着关键作用。欧洲胸科影像学会（ESTI）已制定了一项结节管理建议，以改善对筛查期间发现的肺结节的处理。对于实性结节，评估恶性可能性的主要方法是使用容积测量软件监测结节生长。对于亚实性结节，其侵袭性通过测量实性部分来确定。ESTI建议强化了现有方案，但更加强调病变的侵袭性。主要目标是尽量减少随访检查的总数，同时防止出现重大分期转变的风险并降低过度治疗的风险。关键点：问题 根据指南评估结节生长和管理在肺癌筛查中至关重要。发现 评估结节的侵袭性决定了肺癌筛查中的随访。临床意义 ESTI结节管理建议旨在减少随访检查，同时防止重大分期转变和过度治疗。
