Early-detection demo · Lung cancer

9 mm part-solid nodule on LDCT — Lung-RADS 4A

9 mm part-solid nodule with 4 mm solid component — Lung-RADS 4A; growth from baseline.

Patient: Carmen · 62 · 35 pack-year smokerModality: CTRisk: high · 68/100
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01

Risk profile

What OCTON knew before the scan
Risk
68
high
Tier
high
Quit smoking 6 years ago after 35 pack-year history. Eligible for USPSTF 2021 LDCT screening (50–80, ≥20 pack-year, current or quit ≤15 yrs). 3rd annual LDCT.
Contributing factors
  • 35 pack-year smoking history+30
  • Age 62+14
  • Quit <15 years ago+12
  • COPD (FEV1 65%)+8
  • Asbestos occupational exposure+4
Narrative

Carmen is squarely in the screening-eligible cohort. Her 30-pack-year exposure (>=20) and quit-window (<=15 yrs) put her at high relative risk; 3rd-annual LDCT is the standard pathway.

02

Scan + AI report

What CT found · Low-dose chest CT, 1 mm slice, lung window
CT · DEMO
Lung-RADS 4A
OCTON · scanning · live
conf 0.81
OCTON Impression · 81% confidence

9 mm part-solid nodule in the right upper lobe with a 4 mm solid component. Has grown from a 6 mm pure-ground-glass on baseline CT 24 months ago — concerning for adenocarcinoma in situ progressing to minimally invasive adenocarcinoma.

Findings
  • 9 mm part-solid nodule, RUL apicoposterior segment · Right upper lobe9 mm
  • 4 mm solid component within the ground-glass halo · Nodule4 mm
  • Growth: 6 mm → 9 mm over 24 months (50% diameter) · Nodule (longitudinal)
  • No lymphadenopathy, no pleural effusion · Mediastinum, pleura
Differential diagnosis
  • Adenocarcinoma in situ → MIA (lepidic-pattern progression)55%
  • Atypical adenomatous hyperplasia18%
  • Resolving inflammation / organizing pneumonia15%
  • Granuloma7%
  • Hamartoma5%
Recommended actions
  • ▸PET-CT (FDG) within 2 weeks to characterize solid component
  • ▸Pulmonology referral for navigational bronchoscopic biopsy or CT-guided FNA
  • ▸Multidisciplinary thoracic-tumor-board review
  • ▸If confirmed AIS/MIA: lobectomy or sublobar resection (segmentectomy)
Caveats
  • Low-attenuation ground-glass components have low FDG avidity — PET specificity drops for sub-cm GGNs.
  • AIS/MIA has 100% 5-year disease-specific survival when fully resected — early catch is decisive.
03

360° Preventative plan

Drugs · surveillance · diet · exercise · lifestyle — generated for this case
Clinical anchors
Drugs · labs · imaging · surveillance
Medical
Low-dose chest CT (LDCT)
FrequencyAnnual · 3-monthly follow-up post-finding until stable or resolved
Startsage 50
USPSTF 2021 Grade B · Lung-RADS v2022
Medical
PET-CT FDG
FrequencyWithin 2 weeks (current finding)
Startsage 62
Fleischner 2017 part-solid nodule management
Lifestyle 360°
Diet · exercise · sleep · stress — the behaviours that move the needle
Lifestyle
Smoking-cessation reinforcement + pneumococcal/flu vaccination
FrequencyAnnual
Startsage 50
ACS 2024
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What changed

The early-detection win

Carmen's first LDCT showed a 6 mm pure-ground-glass nodule the radiologist coded Lung-RADS 2 (benign-appearing). On her 3rd annual scan, OCTON's longitudinal compare flagged 50% diameter growth and a new 4 mm solid component — Lung-RADS 4A. Wedge resection found AIS with a 3 mm focus of invasion (MIA, T1mi N0 M0, Stage IA1). 5-year disease-specific survival for resected MIA: 100%.

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