文章：

肺癌筛查中的偶发发现

Incidental Findings in Lung Cancer Screening

原文发布日期：20 July 2024

DOI: 10.3390/cancers16142600

类型: Article

开放获取: 是

英文摘要：

While low-dose computed tomography (LDCT) for lung cancer screening (LCS) has been recognized for its effectiveness in reducing lung cancer mortality, it often simultaneously leads to the detection of incidental findings (IFs) unrelated to the primary screening indication. These IFs present diagnostic and management challenges, potentially causing unnecessary anxiety and further invasive diagnostic procedures for patients. This review article provides an overview of IFs encountered in LDCT, emphasizing their clinical significance and recommended management strategies. We categorize IFs based on their anatomical locations (intrathoracic–intrapulmonary, intrathoracic–extrapulmonary, and extrathoracic) and discuss the most common findings. We highlight the importance of utilizing guidelines and standardized reporting systems by the American College of Radiology (ACR) to guide appropriate follow-ups. For each category, we present specific IF examples, their radiologic features, and the suggested management approach. This review aims to provide radiologists and clinicians with a comprehensive understanding of IFs in LCS for accurate assessment and management, ultimately enhancing patient care. Finally, we outline a few key aspects for future research and development in managing IFs.

摘要翻译： 

尽管低剂量计算机断层扫描（LDCT）用于肺癌筛查（LCS）已被证实能有效降低肺癌死亡率，但其常同时检测到与主要筛查指征无关的偶发发现（IFs）。这些偶发发现带来了诊断和处理上的挑战，可能给患者造成不必要的焦虑并引发进一步有创诊断程序。本文综述了LDCT中遇到的偶发发现，重点阐述其临床意义及推荐处理策略。我们根据解剖位置（胸内-肺内、胸内-肺外及胸外）对偶发发现进行分类，并讨论最常见的发现类型。我们强调采用美国放射学会（ACR）指南和标准化报告系统指导规范随访的重要性。针对每个类别，我们列举具体偶发发现实例，描述其影像学特征并提出相应处理建议。本综述旨在帮助放射科医师和临床医生全面理解肺癌筛查中的偶发发现，以实现准确评估和规范管理，最终提升患者照护质量。最后，我们提出了未来在偶发发现管理研究中需要重点关注的若干方向。

原文链接：

Incidental Findings in Lung Cancer Screening