Screening Detects Smaller, Slower-Growing Lung Tumours

Investigating CT Features

Researchers reviewed CT scans and evaluated several imaging features of the detected nodules such as, tumour size and nodule location within the lung.

Tumour growth was measured using volume doubling time (VDT), VDT values between ADCs and non-ADCs were compared to determine whether growth patterns differed between tumour types.

Lung cancers were classified according to their histological subtype, allowing the researchers to compare imaging findings between adenocarcinomas and other lung cancer types.

Researchers compared CT characteristics and growth metrics between ADC and non-ADC tumours to identify features associated with adenocarcinoma. Associations between tumour location, pleural attachment, size, and growth rate were analysed.

Distinct CT Features Identified in Screen-Detected ADCs

Lesions in the lower and middle lobes had lower odds of ADC compared with upper lobe lesions and attached to the pleura had substantially higher odds of ADC than centrally located nodules.

Among the 213 screen-detected lung cancer cases included in the study, 67.5% were ADCs and 32.5% were non-ADCs. The mean age of participants was 64 years, 82.4% were male, and 43.2% were former smokers.

ADCs were more frequently diagnosed at an early stage than non-ADCs. Overall, 86.1% of ADCs were stage I-II disease, compared with 47.8% of non-ADCs.

Researchers found that ADCs were significantly smaller at detection. The mean maximum lesion diameter was 14.6 mm for ADCs and 17.3 mm for non-ADCs. ADCs also had longer volume doubling times.

Location differed between tumour types. ADCs were more commonly found in the right upper lobe, and most cancers were solid lesions.

Researchers found that ADCs were more frequently attached to the pleura than non-ADCs and pleura-attached lesions had significantly higher odds of being ADCs than centrally located nodules.

Implications of Low-dose CT

Researchers concluded that adenocarcinomas detected through low-dose CT screening exhibit distinct imaging and growth characteristics, including smaller size, slower growth, upper-lobe predominance, and pleural attachment, these patterns could help improve diagnostic interpretation and support more personalized management of pulmonary nodules.

Reference:

Zepeda S et al. Associations between CT characteristics of lung cancer lesions and histologic subtypes in lung cancer screening. Eur Radiol.2026. DOI;10.1007/s00330-026-12912-x.