Figure - PMC

Skip to main content

An official website of the United States government

Here's how you know

Here's how you know

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock ( ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

View full-text article in PMC

. 2023 Jan 12;41(12):2191–2200. doi: 10.1200/JCO.22.01345

Search in PMC
Search in PubMed
View in NLM Catalog
Add to search

© 2023 by American Society of Clinical Oncology

Creative Commons Attribution Non-Commercial No Derivatives 4.0 License: https://creativecommons.org/licenses/by-nc-nd/4.0/

PMC Copyright notice

FIG 3. — Examples of screening scans with negative clinical interpretations (Lung-RADS 1 or 2) and high Sybil risk scores, who subsequently developed lung cancer. Paired sets of images from four separate subjects from the National Lung Screening Trial and Massachusetts General Hospital cohorts illustrating Sybil's potential in predicting future lung cancer. Clinical (preoperative) or pathologic (postoperative) stages are provided using American Joint Committee on Cancer version 8.³² (A) A 69-year-old man with a 99 pack-year smoking history and LDCT without visible nodules in the right upper lobe (circle; Lung-RADS score 2, Sybil risk 75th percentile). (B) Two years later (after unchanged interval scan at 1 year), a new spiculated solid nodule appeared (arrow), and resection confirmed a 2.2-cm poorly differentiated squamous cancer (pT1cN0M0, stage IA3). (C) A 67-year-old man with a 30 pack-year smoking history and LDCT with a 7-mm solid nodule in the lingula next to the heart (arrow), which was missed because of human error (Lung-RADS score 2, Sybil risk 62nd percentile). (D) One year later, a 1.5-cm solid spiculated nodule was appreciated (arrow), and mediastinal sampling confirmed adenocarcinoma (cT1bN2M0, stage IIIA). (E) A 73-year-old man with an 80 pack-year smoking history and LDCT with a new solid nodule < 6 mm in the left upper lobe, that is, below the size threshold, which would have triggered a 6-month interval scan (Lung-RADS score 2, Sybil risk 65th percentile). (F) Two years later, after missing the recommended annual screen, a solid spiculated nodule was noted (arrow), and resection confirmed a 1.8-cm moderately differentiated squamous cell cancer (pT1bN0M0, stage IA2). (G) A 74-year-old man with 30 pack-year smoking history and LDCT showing an ill-defined cystic airspace in the left apex (arrow; Lung-RADS score 2, Sybil risk 69th percentile). Cyst-associated lung cancers are among the most difficult to recognize early.^32,33 (H) Two years later, the lesion (arrow) had increased in size and resection confirmed a 2.1-cm moderately differentiated adenocarcinoma (invasive size 1.3 cm; pT1bN0M0, stage IA2). LDCT, low-dose computed tomography; Lung-RADS, Lung Imaging Reporting and Data Systems.