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Cancer Imaging

Open Access

Radiological characteristics of screen-detected lung cancers: predictive for histological subtype?

  • MA Heuvelmans1,
  • E Salters1,
  • HJM Groen2,
  • P De Jong3,
  • WPTM Mali3,
  • M Oudkerk1 and
  • R Vliegenthart1
Cancer Imaging201414(Suppl 1):P20

Published: 9 October 2014


To evaluate CT-morphological features of lung cancers detected in a CT lung cancer screening trial, and to determine the correlation between CT-morphological features and the histopathological diagnosis of screen-detected cancers.


197 solid lung cancers (192 participants) detected in all four screening rounds of the Dutch-Belgian randomized lung cancer screening trial (NELSON) were included. CT-morphological features included nodule shape, margin, location, volume, and volume-doubling time (VDT). Based on histopathology, cancers were divided into four groups: adenocarcinoma (N=114), squamous cell carcinoma (N=37), large cell carcinoma (N=28) and neuro-endocrine cancers (N=18). Data were analyzed using ANOVA, Chi-square and Fischer’s exact test.


Mean participant age was 61.3 years (95%-confidence interval [CI]: 60.5-62.2), and 160/192 (83.3%) were male. In all four histopathologic groups, the majority of cancers had a spherical nodule shape (70.6-95.8%). Margins of malignant nodules were most often lobulated (39.3-45.9%) and spiculated (22.2-35.7%), without statistically significant difference between histopathological groups. Most cancers (63.5%) were located in the upper lobes, adenocarcinomas significantly more often (71,1%) than other types of cancers (p=0.004). Adenocarcinomas had a higher mean VDT than large cell carcinomas (214.8 days, 95%-CI: 186.2-243.4 days vs 96.8 days, 95%-CI: 15.8-177.9 days [p<0.05]). VDTs of other histopathological subgroups did not differ significantly.


Only VDT and location in the upper versus lower lobes are associated with histopathological diagnosis of screen-detected lung cancers. No discrimination can be made between different histopathologic cancer types based on CT-morphological features alone.

Authors’ Affiliations

Center for Medical Imaging – North East Netherlands, Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
Department of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands


© Heuvelmans et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.