• David O Wilson, Adam Ryan, Carl Fuhrman, Matthew Schuchert, Steven Shapiro, Jill M Siegfried, and Joel Weissfeld.
• Department of Medicine, Heart, Lung and Esophageal Surgery Institute, University of Pittsuburgh, Pittsburgh, PA 15232, USA. wilsondo@upmc.edu
• Am. J. Respir. Crit. Care Med.. 2012 Jan 1;185(1):85-9.

RationaleAs computed tomography (CT) screening for lung cancer becomes more widespread, volumetric analyses, including doubling times, of CT-screen detected lung nodules and lung cancers may provide useful information in the follow-up and management of CT-detected lung nodules and cancers.ObjectivesTo analyze doubling times in CT screen detected lung cancers and compare prevalent and nonprevalent cancers and different cell types on non small cell lung cancer.MethodsWe performed volumetric and doubling time analysis on 63 non–small cell lung cancers detected as part of the Pittsburgh Lung Screening Study using a commercially available VITREA 2 workstation and VITREA VITAL nodule segmentation software.Measurements And Main ResultsDoubling times (DT) were divided into three groups: rapid (DT<183 d), typical (DT 183–365 d), and slow (DT>365 d). Adenocarcinoma/bronchioloalveolar carcinoma comprised 86.7% of the slow DT group compared with 20% of the rapid DT group. Conversely, squamous cell cancer comprised 60% of the rapid DT group compared with 3.3% of the slow DT group. Twenty-eight of 42 (67%) prevalent and 2 of 21 (10%) nonprevalent cancers were in the slow DT group (P<0.0001; Fisher's exact test). Twenty-four of 32 (75%) prevalent and 1 of 11 (9%) nonprevalent adenocarcinomas were in the slow DT group (P<0.0002; Fisher's exact test).ConclusionsVolumetric analysis of CT-detected lung cancers is particularly useful in AC/BAC. Prevalent cancers have a significantly slower DT than nonprevalent cancers and a higher percentage of adenocarcinoma/bronchioloalveolar carcinoma. These results should affect the management of indeterminant lung nodules detected on screening CT scans.

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