Mr. Lam, a non-smoker with no unusual respiratory symptoms, underwent a health check-up at Tam Anh General Clinic District 7. A low-dose chest CT scan, supported by the Somatom Force CT system, revealed a 3 mm nodule in his right lung, classified as Lung-RADS 2.

Master of Science, Doctor Le Thi Lan Huong, from the Imaging Diagnostics unit, explained that Lung-RADS is a classification system used to evaluate lung nodules on low-dose CT scans. A Lung-RADS 2 classification indicates a small lesion requiring further monitoring. Many lung nodules, only a few millimeters in size, are easily missed or difficult to assess without continuous follow-up.

Mr. Lam’s lung nodule results were stored on the PACS (picture archiving and communication system). During a subsequent follow-up visit, doctors used the syngo.via image analysis software, integrated with artificial intelligence (AI), to compare and assess the lesion's progression.

By the eighth month of follow-up, the AI calculated that the lung nodule had rapidly grown to 9x14 mm, increasing three times its initial size. This rapid growth is a common indicator of malignant lesions.

The AI analyzed image data from both time points and calculated a tumor doubling time of approximately 55 days. According to Doctor Huong, this is a crucial indicator of rapid lesion development and a high risk of cancer. The patient's lung lesion risk level was elevated from Lung-RADS 2 to Lung-RADS 4X, the highest category.

Mr. Lam’s lung nodule at his first examination (left) and after eight months of follow-up (right). Photo: Tam Anh General Hospital

Doctor of Second Degree Specialist Nguyen Van Phuc, Head of the Imaging Diagnostics unit, explained that doubling time is a key metric used to assess lung nodule growth. Numerous studies indicate that malignant lung tumors typically have a doubling time between 30 and 400 days, whereas benign lesions usually grow very slowly or remain unchanged.

The patient was scheduled for a PET/CT scan and biopsy. The results confirmed cancer in the right lung. Following an interdisciplinary consultation, doctors performed a radical tumor resection using the Da Vinci Xi robot. Pathology confirmed early-stage lung cancer, with the tumor localized and no metastasis detected.

According to Doctor Phuc, low-dose chest CT helps detect many small lung nodules, but distinguishing between benign and malignant ones remains a challenge. In Mr. Lam's case, the AI system utilized previously stored CT image data to measure the lesion's 3D volume at two different times, then estimated its growth rate. This approach reduces errors compared to simply measuring diameter, helping doctors accurately assess malignancy risk and intervene promptly.

Lung cancer has a high mortality rate. According to Globocan 2022, Vietnam records approximately 24,400 new cases and over 22,500 deaths from lung cancer annually.

Doctors recommend that individuals 40 years and older or those with risk factors undergo regular health check-ups and specialized tests as needed. The combination of low-dose chest CT with AI enables early lung cancer detection, even when lesions are small.

Nhu Ngoc