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Table 2 Benchmark of Proposed Nodule Management Schedule against Existing Protocols

From: Optimizing the timing of diagnostic testing after positive findings in lung cancer screening: a proof of concept radiomics study

Recommendations No. of participants (%, by column) Lung Cancer diagnosed Cancer-free
within 3 mos (n = 31) within 3–12 mos (n = 20) after 12 mos (n = 10) by study end (n = 31)
AATS guideline, 2012
 Diagnostic workup 13 (14.1) 3 (9.7) 0 (0.0) 1 (10.0) 9 (29.0)
 Follow-up in 3 mos 2 (2.2) 0 (0.0) 0 (0.0) 0 (0.0) 2 (6.5)
 Follow-up in 3–6 mos 52 (56.5) 21 (67.7) 15 (75.0) 4 (40.0) 12 (38.7)
 Follow-up in 6 mos 25 (27.2) 7 (22.6) 5 (25.0) 5 (50.0) 8 (25.8)
ACCP Guideline, 2013
 Diagnostic workup 1 (1.1) 0 (0.0) 0 (0.0) 0 (0.0) 1 (3.2)
 Follow-up at 3 mos 72 (78.2) 23 (74.2) 15 (75.0) 8 (80.0) 26 (83.9)
 Follow-up in 6–12 mos 2 (2.2) 0 (0.0) 0 (0.0) 0 (0.0) 2 (6.5)
 Annual screen 16 (17.4) 8 (25.8) 5 (25.0) 1 (10.0) 2 (6.5)
 No further evaluation 1 (1.1) 0 (0.0) 0 (0.0) 1 (10.0) 0 (0.0)
 China Guideline, 2018
 Follow-up after 1 mosa 32 (34.8) 15 (48.4) 6 (30.0) 0 (0.0) 11 (35.5)
 Follow-up after 3 mos 56 (60.9) 15 (48.4) 13 (65.0) 9 (90.0) 19 (61.3)
 Annual screen 4 (4.3) 1 (3.2) 1 (5.0) 1 (10.0) 1 (3.2)
Lung-RADS, 2019 or NCCN Guideline, 2020b
 Diagnostic workup 42 (45.7) 16 (51.6) 7 (35.0) 1 (10.0) 18 (58.1)
 Follow-up in 3 mos 14 (15.2) 0 (0.0) 3 (15.0) 2 (20.0) 9 (29.0)
 Follow-up in 6 mos 18 (19.6) 7 (22.6) 5 (25.0) 4 (40.0) 2 (6.5)
 Annual screen 18 (19.6) 8 (25.8) 5 (25.0) 3 (30.0) 2 (6.5)
Proposed radiomics approach
 Diagnostic workup 26 (28.3) 19 (61.3) 6 (30.0) 1 (10.0) 0 (0.0)
 Follow-up in 3 mos 42 (45.7) 11 (35.5) 14 (70.0) 9 (90.0) 8 (25.8)
 Annual screen 24 (26.1) 1 (3.2) 0 (0.0) 0 (0.0) 23 (74.2)
  1. AATS: American Association for Thoracic Surgery; ACCP: American College of Chest Physicians; Lung-RADS: Lung CT Screening Reporting & Data System; NCCN: National Comprehensive Cancer Network
  2. aAfter tentative anti-inflammatory therapy
  3. bLung-RADS (baseline screening) and NCCN guidelines have only small differences regarding management of perifissural nodules and the diameter criteria for different follow-up timings among non-solid nodules, which did not result in a difference in terms of nodule management with our data