Radiographic imaging of bronchioloalveolar carcinoma: Screening, patterns of presentation and response assessment

David R Gandara, Denise Aberle, Derick H Lau, James Jett, Tim Akhurst, James Mulshine, Christine Berg, Edward F. Patz

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Bronchioloalveolar carcinoma (BAC) is a previously uncommon subset of adenocarcinoma with unique epidemiology, pathology, radiographic presentation, clinical features, and natural history compared with other non-small cell lung cancer (NSCLC) subtypes. Classically, BAC demonstrates a relatively slow growth pattern and indolent clinical course. However, in a subset of patients, rapid growth and death from bilateral diffuse consolidative disease occurs within months of diagnosis or recurrence. Recent data suggest that the incidence of BAC is increasing, notably in younger nonsmoking women. The initial radiographic presentation of BAC varies considerably, from single ground glass opacities (GGOs) or nodules of mixed ground glass and solid attenuation to diffuse consolidative or bilateral multinodular disease. The rising incidence of BAC is also reflected in recent lung cancer screening studies employing helical computed tomography (CT), where the differential diagnosis of GGOs includes not only BAC and overt adenocarcinoma, but inflammatory disease, focal fibrosis, and atypical adenomatous hyperplasia. Because advanced-stage BAC presents as measurable mass lesions in fewer than 50% of cases, determination of radiographic response to therapy by standard criteria is often difficult. Here, we review current data regarding the radiographic imaging of BAC: its radiographic presentations in asymptomatic early-stage and in advanced-stage disease, the functional imaging characteristics of BAC, and challenges of response assessment, including evolving opportunities for computer-assisted image analysis.

Original languageEnglish (US)
JournalJournal of Thoracic Oncology
Volume1
Issue number9 SUPPL.
StatePublished - Nov 2006

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Bronchiolo-Alveolar Adenocarcinoma
Glass
Adenocarcinoma
Computer-Assisted Image Processing
Spiral Computed Tomography
Incidence
Growth
Natural History
Early Detection of Cancer
Non-Small Cell Lung Carcinoma
Hyperplasia
Lung Neoplasms
Epidemiology
Differential Diagnosis
Fibrosis
Pathology
Recurrence

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Cite this

Radiographic imaging of bronchioloalveolar carcinoma : Screening, patterns of presentation and response assessment. / Gandara, David R; Aberle, Denise; Lau, Derick H; Jett, James; Akhurst, Tim; Mulshine, James; Berg, Christine; Patz, Edward F.

In: Journal of Thoracic Oncology, Vol. 1, No. 9 SUPPL., 11.2006.

Research output: Contribution to journalArticle

Gandara, David R ; Aberle, Denise ; Lau, Derick H ; Jett, James ; Akhurst, Tim ; Mulshine, James ; Berg, Christine ; Patz, Edward F. / Radiographic imaging of bronchioloalveolar carcinoma : Screening, patterns of presentation and response assessment. In: Journal of Thoracic Oncology. 2006 ; Vol. 1, No. 9 SUPPL.
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