Vancouver Risk Calculator Compared with ACR Lung-RADS in Predicting Malignancy

Analysis of the National Lung Screening Trial

Charles S. White, Ekta Dharaiya, Sandeep Dalal, Rong Chen, Linda B. Haramati

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose To compare the Vancouver risk calculator (VRC) with American College of Radiology (ACR) Lung Imaging Reporting and Data System (Lung-RADS) in predicting the risk of malignancy in the National Lung Screening Trial (NLST). Materials and Methods A total of 2813 patients with 4408 nodules (4078 solid, 330 subsolid) were available from the NLST for evaluation. Nodules were scored by using VRC with nine parameters (output was the percentage likelihood of malignancy; VRC threshold for malignancy likelihood set as greater than 5%) and Lung-RADS (output was category 2-4B; malignancy defined as category 4A or 4B; malignancy likelihood greater than 5%). Lung-RADS and VRC were compared for sensitivity, specificity, and accuracy for malignancy on a per-nodule and per-patient basis. Results Of 4408 total nodules, 100 of 4078 (2.5%) solid nodules were malignant and 10 of 330 (3%) subsolid nodules were malignant. On an overall per-nodule basis, the sensitivity, specificity, and accuracy for VRC and Lung-RADS were 93%, 90%, and 90% for VRC and 87%, 83%, and 83% for Lung-RADS, respectively (P = .077, P < .001, and P < .001, respectively). On a per-patient basis, the sensitivity, specificity, and accuracy for VRC and Lung-RADS were 93%, 85%, and 85% for VRC and 87%, 76%, and 76% for Lung-RADS, respectively (P = .077, P < .001, and P < .001, respectively). Conclusion The Vancouver risk calculator had superior overall accuracy than the Lung Imaging Reporting and Data System in predicting malignancy in the National Lung Screening Trial for total nodules, as well as on a per-patient basis.

Original languageEnglish (US)
Pages (from-to)205-211
Number of pages7
JournalRADIOLOGY
Volume291
Issue number1
DOIs
StatePublished - Apr 1 2019

Fingerprint

Radiology
Information Systems
Lung
Neoplasms
Sensitivity and Specificity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Vancouver Risk Calculator Compared with ACR Lung-RADS in Predicting Malignancy : Analysis of the National Lung Screening Trial. / White, Charles S.; Dharaiya, Ekta; Dalal, Sandeep; Chen, Rong; Haramati, Linda B.

In: RADIOLOGY, Vol. 291, No. 1, 01.04.2019, p. 205-211.

Research output: Contribution to journalArticle

White, Charles S. ; Dharaiya, Ekta ; Dalal, Sandeep ; Chen, Rong ; Haramati, Linda B. / Vancouver Risk Calculator Compared with ACR Lung-RADS in Predicting Malignancy : Analysis of the National Lung Screening Trial. In: RADIOLOGY. 2019 ; Vol. 291, No. 1. pp. 205-211.
@article{881ee79a35cb4f7d95d951eb141bb498,
title = "Vancouver Risk Calculator Compared with ACR Lung-RADS in Predicting Malignancy: Analysis of the National Lung Screening Trial",
abstract = "Purpose To compare the Vancouver risk calculator (VRC) with American College of Radiology (ACR) Lung Imaging Reporting and Data System (Lung-RADS) in predicting the risk of malignancy in the National Lung Screening Trial (NLST). Materials and Methods A total of 2813 patients with 4408 nodules (4078 solid, 330 subsolid) were available from the NLST for evaluation. Nodules were scored by using VRC with nine parameters (output was the percentage likelihood of malignancy; VRC threshold for malignancy likelihood set as greater than 5{\%}) and Lung-RADS (output was category 2-4B; malignancy defined as category 4A or 4B; malignancy likelihood greater than 5{\%}). Lung-RADS and VRC were compared for sensitivity, specificity, and accuracy for malignancy on a per-nodule and per-patient basis. Results Of 4408 total nodules, 100 of 4078 (2.5{\%}) solid nodules were malignant and 10 of 330 (3{\%}) subsolid nodules were malignant. On an overall per-nodule basis, the sensitivity, specificity, and accuracy for VRC and Lung-RADS were 93{\%}, 90{\%}, and 90{\%} for VRC and 87{\%}, 83{\%}, and 83{\%} for Lung-RADS, respectively (P = .077, P < .001, and P < .001, respectively). On a per-patient basis, the sensitivity, specificity, and accuracy for VRC and Lung-RADS were 93{\%}, 85{\%}, and 85{\%} for VRC and 87{\%}, 76{\%}, and 76{\%} for Lung-RADS, respectively (P = .077, P < .001, and P < .001, respectively). Conclusion The Vancouver risk calculator had superior overall accuracy than the Lung Imaging Reporting and Data System in predicting malignancy in the National Lung Screening Trial for total nodules, as well as on a per-patient basis.",
author = "White, {Charles S.} and Ekta Dharaiya and Sandeep Dalal and Rong Chen and Haramati, {Linda B.}",
year = "2019",
month = "4",
day = "1",
doi = "10.1148/radiol.2018181050",
language = "English (US)",
volume = "291",
pages = "205--211",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "1",

}

TY - JOUR

T1 - Vancouver Risk Calculator Compared with ACR Lung-RADS in Predicting Malignancy

T2 - Analysis of the National Lung Screening Trial

AU - White, Charles S.

AU - Dharaiya, Ekta

AU - Dalal, Sandeep

AU - Chen, Rong

AU - Haramati, Linda B.

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Purpose To compare the Vancouver risk calculator (VRC) with American College of Radiology (ACR) Lung Imaging Reporting and Data System (Lung-RADS) in predicting the risk of malignancy in the National Lung Screening Trial (NLST). Materials and Methods A total of 2813 patients with 4408 nodules (4078 solid, 330 subsolid) were available from the NLST for evaluation. Nodules were scored by using VRC with nine parameters (output was the percentage likelihood of malignancy; VRC threshold for malignancy likelihood set as greater than 5%) and Lung-RADS (output was category 2-4B; malignancy defined as category 4A or 4B; malignancy likelihood greater than 5%). Lung-RADS and VRC were compared for sensitivity, specificity, and accuracy for malignancy on a per-nodule and per-patient basis. Results Of 4408 total nodules, 100 of 4078 (2.5%) solid nodules were malignant and 10 of 330 (3%) subsolid nodules were malignant. On an overall per-nodule basis, the sensitivity, specificity, and accuracy for VRC and Lung-RADS were 93%, 90%, and 90% for VRC and 87%, 83%, and 83% for Lung-RADS, respectively (P = .077, P < .001, and P < .001, respectively). On a per-patient basis, the sensitivity, specificity, and accuracy for VRC and Lung-RADS were 93%, 85%, and 85% for VRC and 87%, 76%, and 76% for Lung-RADS, respectively (P = .077, P < .001, and P < .001, respectively). Conclusion The Vancouver risk calculator had superior overall accuracy than the Lung Imaging Reporting and Data System in predicting malignancy in the National Lung Screening Trial for total nodules, as well as on a per-patient basis.

AB - Purpose To compare the Vancouver risk calculator (VRC) with American College of Radiology (ACR) Lung Imaging Reporting and Data System (Lung-RADS) in predicting the risk of malignancy in the National Lung Screening Trial (NLST). Materials and Methods A total of 2813 patients with 4408 nodules (4078 solid, 330 subsolid) were available from the NLST for evaluation. Nodules were scored by using VRC with nine parameters (output was the percentage likelihood of malignancy; VRC threshold for malignancy likelihood set as greater than 5%) and Lung-RADS (output was category 2-4B; malignancy defined as category 4A or 4B; malignancy likelihood greater than 5%). Lung-RADS and VRC were compared for sensitivity, specificity, and accuracy for malignancy on a per-nodule and per-patient basis. Results Of 4408 total nodules, 100 of 4078 (2.5%) solid nodules were malignant and 10 of 330 (3%) subsolid nodules were malignant. On an overall per-nodule basis, the sensitivity, specificity, and accuracy for VRC and Lung-RADS were 93%, 90%, and 90% for VRC and 87%, 83%, and 83% for Lung-RADS, respectively (P = .077, P < .001, and P < .001, respectively). On a per-patient basis, the sensitivity, specificity, and accuracy for VRC and Lung-RADS were 93%, 85%, and 85% for VRC and 87%, 76%, and 76% for Lung-RADS, respectively (P = .077, P < .001, and P < .001, respectively). Conclusion The Vancouver risk calculator had superior overall accuracy than the Lung Imaging Reporting and Data System in predicting malignancy in the National Lung Screening Trial for total nodules, as well as on a per-patient basis.

UR - http://www.scopus.com/inward/record.url?scp=85063645952&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85063645952&partnerID=8YFLogxK

U2 - 10.1148/radiol.2018181050

DO - 10.1148/radiol.2018181050

M3 - Article

VL - 291

SP - 205

EP - 211

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 1

ER -