Imaging diagnosis of bronchogenic carcinoma (the forgotten disease) during times of COVID-19 pandemic: Current and future perspectives

Table 1 Imaging priorities for bronchogenic carcinoma

High priority	Medium priority	Low priority
Patients with significant respiratory symptoms and/or cancer-related or treatment-related symptoms. In patients with new onset respiratory symptoms such as dyspnoea, cough with or without fever, a CT scan is recommended	Follow-up imaging for high/intermediate risk of relapse in a year after completion of radical treatment	Follow-up imaging for high/intermediate risk of relapse more than 1 yr after completion of radical treatment
Standard staging work-up for suspected invasive cancer of unknown stage or stage II/III/IV	Standard staging work-up for early lung cancer (stage I)	Follow-up imaging after radical treatment in low-risk of relapse scenario
Biopsies for suspicious nodules or mass for suspected invasive cancer or stage III/IV	Biopsies for suspicious nodules or mass for suspected invasive cancer of unknown stage or stage I/II
Evaluation of active treatment response in the first 6 mo of treatment or for suspicion of tumour progression at any point of time	Evaluation of active treatment response beyond 6 mo of treatment if stable/ controlled situation
	Follow-up of nodules of incidental finding with either: (1) Partially solid nodule with a non-solid component of ≥ 8 mm in size; (2) Known VDT 400 d to 600 d; (3) Solid nodule 50 mm3 to 500 mm3; and (4) Pleural-based solid nodule 5 mm to 10 mm in size	Follow-up of nodules of incidental finding with either: (1) Partially solid nodule with a non-solid component of < 8 mm in size; (2) Known VDT > 600 d; (3) Solid nodule < 50 mm3; (4) Pleural-based solid nodule < 5 mm in size; (5) Non-solid nodule < 8 mm in size; and (6) Benign morphology
Pre-planned imaging evaluation per clinical trial protocol		Lung cancer screening can be deferred until the COVID-19 pandemic resolves — it is reasonable for patients in the general population to defer screening low-dose CT, a deferral that is not likely to have an impact on overall survival

COVID-19: Coronavirus disease 2019; CT: Computed tomography; VDT: Volume doubling time.