PT  - JOURNAL ARTICLE
AU  - Onno M. Mets
AU  - Kaman Chung
AU  - Pieter Zanen
AU  - Ernst T. Scholten
AU  - Wouter B. Veldhuis
AU  - Bram van Ginneken
AU  - Mathias Prokop
AU  - Cornelia M. Schaefer-Prokop
AU  - Pim A. de Jong
TI  - <em>In vivo</em> growth of 60 non-screening detected lung cancers: a computed tomography study
AID  - 10.1183/13993003.02183-2017
DP  - 2018 Apr 01
TA  - European Respiratory Journal
PG  - 1702183
VI  - 51
IP  - 4
4099  - http://erj.ersjournals.com/content/51/4/1702183.short
4100  - http://erj.ersjournals.com/content/51/4/1702183.full
SO  - Eur Respir J2018 Apr 01; 51
AB  - Current pulmonary nodule management guidelines are based on nodule volume doubling time, which assumes exponential growth behaviour. However, this is a theory that has never been validated in vivo in the routine-care target population. This study evaluates growth patterns of untreated solid and subsolid lung cancers of various histologies in a non-screening setting.Growth behaviour of pathology-proven lung cancers from two academic centres that were imaged at least three times before diagnosis (n=60) was analysed using dedicated software. Random-intercept random-slope mixed-models analysis was applied to test which growth pattern most accurately described lung cancer growth. Individual growth curves were plotted per pathology subgroup and nodule type.We confirmed that growth in both subsolid and solid lung cancers is best explained by an exponential model. However, subsolid lesions generally progress slower than solid ones. Baseline lesion volume was not related to growth, indicating that smaller lesions do not grow slower compared to larger ones.By showing that lung cancer conforms to exponential growth we provide the first experimental basis in the routine-care setting for the assumption made in volume doubling time analysis.Lung cancers in vivo conform to an exponential growth pattern http://ow.ly/ps0L30jN1LD