Jong Hyuk Lee1, Chang Min Park2,3,4, Sang Min Lee5, Hyungjin Kim1,6, H Page McAdams7, Jin Mo Goo1,8. 1. Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea. 2. Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea. cmpark.morphius@gmail.com. 3. Cancer Research Institute, Seoul National University, Seoul, Korea. cmpark.morphius@gmail.com. 4. Department of Radiology, Duke University Medical Center, Durham, NC, USA. cmpark.morphius@gmail.com. 5. Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. 6. Aerospace Medical Group, Air Force Education and Training Command, Jinju, Korea. 7. Department of Radiology, Duke University Medical Center, Durham, NC, USA. 8. Cancer Research Institute, Seoul National University, Seoul, Korea.
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.
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.
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