Incidence and Resource Burden for the Management of CT-detected Ground-Glass Opacities at a Tertiary Lung Cancer Service in the United Kingdom

This is the authors' abstract. We don't add key points for this paper.

OBJECTIVES: The increased use of CT for lung cancer screening has significantly raised awareness of pure ground-glass opacity (pGGO) lesions. GGOs pose diagnostic challenges, ranging from benign findings to invasive adenocarcinomas. We aim to evaluate the incidence of pGGOs identified on CT at a tertiary UK lung cancer service and quantify their impact on time and healthcare resources. DESIGN & SETTING: We conducted a retrospective review of patients with pGGOs discussed at multi-disciplinary team (MDT) meetings between 2017 and 2019 at the Royal Free and Royal Brompton Hospitals. Demographics were recorded, and annual incidence along with management data was analysed. RESULTS: A total of 3731 patients were discussed at MDTs during the specified timeframe. On initial review 401 cases (11%) discussed were identified on CT as exhibiting areas of ground-glass change, with the annual incidence increasing from 8% in 2017 to 13% in 2019. Following a second stage detailed assessment of the cases and application of exclusion criteria-such as the presence of a part-solid component-259 patients were confirmed to have pure GGOs and were included for subsequent analysis in this study. The median number of MDT meetings per GGO was 2 (range: 1-3), with 3 CT scans (range: 2-4) over a median follow-up of 8.7 months (range: 2.0-24.1). PET scans were performed in 74 (27%) patients, 40 (15%) underwent biopsies (62.5% confirming malignancy), and 24 (9%) proceeded to surgery. CONCLUSIONS: The rising incidence of GGOs presents a growing resource burden, with repeated MDT discussions, imaging, and interventions. Revised guidelines with improved risk stratification models are essential to optimize management, reduce unnecessary follow-up, and improve resource utilization in lung cancer services.