Update: The 10 Pillars of Lung Cancer Screening-Rationale and Logistics of a Lung Cancer Screening Program.

- Update articles supplement or update information found in full-length articles previously published in . These updates, written by at least one author of the previous article, provide a brief synopsis that emphasizes important new information such as technological advances, revised imaging protocols, new clinical guidelines involving imaging, or updated classification schemes.

Role of sex in lung cancer risk prediction based on single low-dose chest computed tomography.

A validated open-source deep-learning algorithm called Sybil can accurately predict long-term lung cancer risk from a single low-dose chest computed tomography (LDCT). However, Sybil was trained on a majority-male cohort. Use of artificial intelligence algorithms trained on imbalanced cohorts may lead to inequitable outcomes in real-world settings.

E-Cigarette Use, Small Airway Fibrosis, and Constrictive Bronchiolitis.

Background: Vaping, including the use of electronic cigarettes (e-cigarettes), has become increasingly prevalent, yet the associated long-term health risks are largely unknown. Given the prevalence of use, particularly among adolescents early in their lifespan, it is vital to understand the potential chronic pathologic sequelae of vaping.

Methods: We present the cases of four patients with chronic lung disease associated with e-cigarette use characterized by clinical evaluation, with pulmonary function tests (PFTs), chest high-resolution computed tomography (HRCT), endobronchial optical coherence tomography (EB-OCT) imaging, and histopathologic assessment.

Validation of a Deep Learning-Based Model to Predict Lung Cancer Risk Using Chest Radiographs and Electronic Medical Record Data.

Importance: Lung cancer screening with chest computed tomography (CT) prevents lung cancer death; however, fewer than 5% of eligible Americans are screened. CXR-LC, an open-source deep learning tool that estimates lung cancer risk from existing chest radiograph images and commonly available electronic medical record (EMR) data, may enable automated identification of high-risk patients as a step toward improving lung cancer screening participation.

Objective: To validate CXR-LC using EMR data to identify individuals at high-risk for lung cancer to complement 2022 US Centers for Medicare & Medicaid Services (CMS) lung cancer screening eligibility guidelines.

Preoperative CT-guided Fiducial Marker Placement for Surgical Localization of Pulmonary Nodules.

Purpose: To assess the technical success and complication rates of CT-guided fiducial marker placement for the localization of pulmonary nodules and to assess the surgical localization failure rate.

Materials And Methods: This was a single-center, retrospective analysis of consecutive patients who underwent CT-guided fiducial marker placement procedures between 2014 and 2020. End points included the technical success of the fiducial marker placement, procedural complications, and the surgical localization failure rate.

Incidence of Radiation Therapy Among Patients Enrolled in a Multidisciplinary Pulmonary Nodule and Lung Cancer Screening Clinic.

Importance: The number of pulmonary nodules discovered incidentally or through screening programs has increased markedly. Multidisciplinary review and management are recommended, but the involvement of radiation oncologists in this context has not been defined.

Objective: To assess the role of stereotactic body radiation therapy among patients enrolled in a lung cancer screening program.

Liquid Biopsy, Diagnostic Imaging, and Future Synergies.

Imaging plays an integral role in the initial diagnosis and longitudinal care of patients with cancer. Liquid biopsies, which most commonly involve genetic analysis of circulating free DNA, have emerged as important complementary tools in cancer care with the potential to interface with imaging at each step of the cancer care continuum. Here, the authors use non-small-cell lung cancer as a paradigm to elucidate factors driving the need for liquid biopsy in the spectrum of lung cancer care, demonstrate ways in which liquid biopsy has already changed standard clinical practice, and discuss anticipated synergies of liquid biopsy and imaging in screening and early detection and in monitoring of disease.

Lung-RADS Category 3 and 4 Nodules on Lung Cancer Screening in Clinical Practice.

Lung-RADS category 3 and 4 nodules account for most screening-detected lung cancers and are considered actionable nodules with management implications. The cancer frequency among such nodules is estimated in the Lung-RADS recommendations and has been investigated primarily by means of retrospectively assigned Lung-RADS classifications. The purpose of this study was to assess the frequency of cancer among lung nodules assigned Lung-RADS category 3 or 4 at lung cancer screening (LCS) in clinical practice and to evaluate factors that affect the cancer frequency within each category.

Comparison of Percutaneous Image-Guided Microwave Ablation and Cryoablation for Sarcoma Lung Metastases: A 10-Year Experience.

. To our knowledge, outcomes between percutaneous microwave ablation (MWA) and cryoablation of sarcoma lung metastases have not been compared. .

Racial and Ethnic Disparities in Lung Cancer Screening Eligibility.

Background To address disparities in lung cancer screening (LCS) that may exclude large numbers of high-risk African American smokers, revised U.S. Preventive Services Task Force (USPSTF) recommendations lowered LCS eligibility thresholds.

Longitudinal CT and MRI Characteristics of Unilocular Thymic Cysts.

Background Isoattenuating and hyperattenuating thymic cysts at CT are often misinterpreted as lymphadenopathy or thymic epithelial neoplasms. Purpose To evaluate the longitudinal change in thymic cyst appearance at CT and MRI. Materials and Methods All chest MRI studies showing thymic cysts between July 2008 and December 2019, identified from a retrospective search of a quality assurance database, were included in this study if initial CT depicted a thymic lesion, the patient was referred for follow-up MRI for characterization, and the baseline (ie, index) MRI indicated a cystic lesion.

Characteristics and Outcomes of Lung Cancers Detected on Low-Dose Lung Cancer Screening CT.

Background: Lung cancer screening (LCS) with low-dose CT (LDCT) was implemented in the United States following the National Lung Screening Trial (NLST). The real-world benefits of implementing LCS are yet to be determined with outcome-oriented data. The study objective is to investigate the characteristics and outcomes of screening-detected lung cancers.

Pulmonary Vascular Manifestations of COVID-19 Pneumonia.

Purpose: To investigate pulmonary vascular abnormalities at CT pulmonary angiography (CT-PE) in patients with coronavirus disease 2019 (COVID-19) pneumonia.

Materials And Methods: In this retrospective study, 48 patients with reverse-transcription polymerase chain reaction-confirmed COVID-19 infection who had undergone CT-PE between March 23 and April 6, 2020, in a large urban health care system were included. Patient demographics and clinical data were collected through the electronic medical record system.

Artificial intelligence-based vessel suppression for detection of sub-solid nodules in lung cancer screening computed tomography.

Background: Lung cancer screening (LCS) with low-dose computed tomography (LDCT) helps early lung cancer detection, commonly presenting as small pulmonary nodules. Artificial intelligence (AI)-based vessel suppression (AI-VS) and automatic detection (AI-AD) algorithm can improve detection of subsolid nodules (SSNs) on LDCT. We assessed the impact of AI-VS and AI-AD in detection and classification of SSNs [ground-glass nodules (GGNs) and part-solid nodules (PSNs)], on LDCT performed for LCS.

Implementation of the Radiological Society of North America Expert Consensus Guidelines on Reporting Chest CT Findings Related to COVID-19: A Multireader Performance Study.

Background: RSNA expert consensus guidelines provide a framework for reporting CT findings related to COVID-19, but have had limited multireader validation.

Purpose: To assess the performance of the RSNA guidelines and quantify interobserver variability in application of the guidelines in patients undergoing chest CT for suspected COVID-19 pneumonia.

Materials And Methods: A retrospective search from 1/15/20 to 3/30/20 identified 89 consecutive CT scans whose radiological report mentioned COVID-19.

Multi-Radiologist User Study for Artificial Intelligence-Guided Grading of COVID-19 Lung Disease Severity on Chest Radiographs.

Rationale And Objectives: Radiographic findings of COVID-19 pneumonia can be used for patient risk stratification; however, radiologist reporting of disease severity is inconsistent on chest radiographs (CXRs). We aimed to see if an artificial intelligence (AI) system could help improve radiologist interrater agreement.

Materials And Methods: We performed a retrospective multi-radiologist user study to evaluate the impact of an AI system, the PXS score model, on the grading of categorical COVID-19 lung disease severity on 154 chest radiographs into four ordinal grades (normal/minimal, mild, moderate, and severe).

PET/MRI assessment of lung nodules in primary abdominal malignancies: sensitivity and outcome analysis.

Purpose: To evaluate PET/MR lung nodule detection compared to PET/CT or CT, to determine growth of nodules missed by PET/MR, and to investigate the impact of missed nodules on clinical management in primary abdominal malignancies.

Methods: This retrospective IRB-approved study included [18F]-FDG PET/MR in 126 patients. All had standard of care chest imaging (SCI) with diagnostic chest CT or PET/CT within 6 weeks of PET/MR that served as standard of reference.

Management and Outcomes of Suspected Infectious and Inflammatory Lung Abnormalities Identified on Lung Cancer Screening CT.

Incidental findings are frequently encountered during lung cancer screening (LCS). Limited data describe the prevalence of suspected acute infectious and inflammatory lung processes on LCS and how they should be managed. The purpose of this study was to determine the prevalence, radiologic reporting and management, and outcome of suspected infectious and inflammatory lung processes identified incidentally during LCS and to propose a management algorithm.