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Certain imaging features on low-dose CT scans can help predict whether a screen-detected lung cancer is an adenocarcinoma. A study found that smaller tumors attached to the pleura and located in the upper lobes were more likely to be adenocarcinomas. Researchers caution, however, that imaging alone isn't enough for a definitive histologic diagnosis — external validation is still needed.
A new observational study suggests that low-dose CT (LDCT) imaging features can offer clues about the histologic subtype of screen-detected lung cancers — specifically, whether a tumor is an adenocarcinoma (ADC) or another subtype. Analyzing 213 participants from the NELSON-POP trial extension, researchers found that ADCs tended to be smaller, more commonly located in the upper lobes, and more frequently attached to the pleura compared with other subtypes like squamous cell carcinoma.
The multivariable model showed that pleural attachment was associated with over sixfold higher odds of ADC, while tumors in the lower and middle lobes were significantly less likely to be ADCs. A longer volume doubling time (VDT) also correlated with higher ADC odds in a sensitivity analysis.
By the Numbers:
Why it matters: Knowing a tumor's histologic subtype early can influence treatment planning, but biopsies aren't always straightforward. These findings are hypothesis-generating and could eventually help clinicians prioritize workup — but only after external validation and integration with clinical and molecular data.
