Persistent pulmonary subsolid nodules with solid portions of 5 mm or smaller: Their natural course and predictors of interval growth

Jong Hyuk Lee, Chang Min Park, Sang Min Lee, Hyungjin Kim, H. Page McAdams, Jin Mo Goo

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26 Scopus citations

Abstract

Objective: To investigate the natural course of persistent pulmonary subsolid nodules (SSNs) with solid portions ≤5 mm and the clinico-radiological features that influence interval growth over follow-ups. Methods: From 2005 to 2013, the natural courses of 213 persistent SSNs in 213 patients were evaluated. To identify significant predictors of interval growth, Kaplan-Meier analysis and Cox proportional hazard regression analysis were performed. Results: Among the 213 nodules, 136 were pure ground-glass nodules (GGNs; growth, 18; stable, 118) and 77 were part-solid GGNs with solid portions ≤5 mm (growth, 24; stable, 53). For all SSNs, lung cancer history (p = 0.001), part-solid GGNs (p < 0.001), and nodule diameter (p < 0.001) were significant predictors for interval growth. On subgroup analysis, nodule diameter was an independent predictor for the interval growth of both pure GGNs (p < 0.001), and part-solid GGNs (p = 0.037). For part-solid GGNs, lung cancer history (p = 0.002) was another significant predictor of the interval growth. Interval growth of pure GGNs ≥10 mm and part-solid GGNs ≥8 mm were significantly more frequent than in pure GGNs <10 mm (p < 0.001) and part-solid GGNs <8 mm (p = 0.003), respectively. Conclusion: The natural course of SSNs with solid portions ≤5 mm differed significantly according to their nodule type and nodule diameters, with which their management can be subdivided. Key Points: • Pure GGNs ≥10 mm have significantly more frequent interval growth than those <10 mm. • Part-solid GGNs ≥8 mm have significantly more frequent interval growth than those <8 mm. • Management of SSNs with solid portions ≤5 mm can be subdivided by diameter.

Original languageEnglish
Pages (from-to)1529-1537
Number of pages9
JournalEuropean Radiology
Volume26
Issue number6
DOIs
StatePublished - 1 Jun 2016

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Keywords

  • Adenocarcinoma in situ
  • Computed tomography
  • Follow-up studies
  • Lung adenocarcinoma
  • Portion size

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