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

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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.

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Abbreviations

SSN:

Subsolid nodule

GGN:

Ground-glass nodule

AAH:

Atypical adenomatous hyperplasia

AIS:

Adenocarcinoma-in-situ

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Acknowledgments

This study was supported by a research grant from the Korean Foundation for Cancer Research (grant number: CB-2011-02-01). The scientific guarantor of this publication is Prof. Dr. Chang Min Park. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding by the Research of the Korean Foundation for Cancer Research (grant number: CB-2011-02-01).One of the authors has significant statistical expertise: Chang Min Park, MD (Seoul National University Hospital). Institutional review board approval was obtained. Requirement of written informed consent was waived by the institutional review board. The study population of the present study was extracted from our ground-glass nodule registry of Seoul National University Hospital. Thus, of the 213 subsolid nodules (SSNs) in 213 patients in this study, some had been reported in our previous studies [17–20]. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  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

    Jong Hyuk Lee, Chang Min Park, Hyungjin Kim & Jin Mo Goo

  2. Cancer Research Institute, Seoul National University, Seoul, Korea

    Chang Min Park & Jin Mo Goo

  3. Department of Radiology, Duke University Medical Center, Durham, NC, USA

    Chang Min Park & H. Page McAdams

  4. Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

    Sang Min Lee

  5. Aerospace Medical Group, Air Force Education and Training Command, Jinju, Korea

    Hyungjin Kim

Authors
  1. Jong Hyuk Lee
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  2. Chang Min Park
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  3. Sang Min Lee
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  4. Hyungjin Kim
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  5. H. Page McAdams
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  6. Jin Mo Goo
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Correspondence to Chang Min Park.

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Lee, J.H., Park, C.M., Lee, S.M. et al. Persistent pulmonary subsolid nodules with solid portions of 5 mm or smaller: Their natural course and predictors of interval growth. Eur Radiol 26, 1529–1537 (2016). https://doi.org/10.1007/s00330-015-4017-4

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  • DOI: https://doi.org/10.1007/s00330-015-4017-4

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