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01-10-2005 | Chest

Resolving small pulmonary nodules: CT features

Authors: S. Diederich, J. Hansen, D. Wormanns

Published in: European Radiology | Issue 10/2005

Abstract

Our aim was to analyse the CT morphology of resolving nodules over time in order seek morphologic features helpful in initial nodule classification. The imaging characteristics of 133 consecutive resolving pulmonary nodules detected in 56 subjects in a screening trial for early lung cancer with low-dose CT were retrospectively reviewed by two readers in consensus. Nodule size ranged from 2 to 28 mm, with a mean diameter of 5.9 mm. The maximum diameter of resolving nodules was ≤5 mm in 71/133 (53%), 6–10 mm in 52/133 (39%), and >10 mm in 10/133 (8%). Their location was mainly peripheral, with a mean distance to the costal pleura of 10 mm. There was no lobe predominance of nodules. In 85% (113/133) of cases the nodules were solid, 77% (103/133) were well-defined, and 73% (97/133) were non-lobulated. Eighty percent (107/133) resolved completely within 14–1,671 (mean 492) days, 20% (26/133) resolved incompletely with residual abnormalities within 51–1,777 (mean 613) days. Resolving pulmonary nodules were mostly ≤10 mm, peripherally located, solid, well-defined, and non-lobulated. Most resolve completely within a variable interval ranging from several days to years.

Remy-Jardin M, Remy J, Giraud F, Marquette C-H (1993) Pulmonary nodules: detection with thick-section spiral CT versus conventional CT. Radiology 187:513–520PubMed

Buckley JA, Scott WW, Siegelman SS et al (1995) Pulmonary nodules: effect of increased data sampling on detection with spiral CT and confidence in diagnosis. Radiology 196:395–400PubMed

Diederich S, Lentschig MG, Winter F et al (1998) Detection of pulmonary nodules with overlapping versus non-overlapping image reconstruction at spiral CT. Eur Radiol 9:281–286CrossRef

Diederich S, Semik M, Lentschig MG et al (1998) Helical CT of pulmonary nodules in patients with extrathoracic malignancy: CT-surgical correlation. Am J Roentgenol 172:353–360

Fischbach F, Knollmann F, Griesshaber V, Freund T, Akkol E, Felix R (2003) Detection of pulmonary nodules by multislice computed tomography: improved detection rate with reduced slice thickness. Eur Radiol 13:2378–2383CrossRefPubMed

Swensen SJ, Jett JR, Hartman TE, Midthun DE, Sloan JA, Sykes AM, Aughenbaugh GL, Clemens MA (2003) Lung cancer screening with CT: Mayo Clinic experience. Radiology 226:756–761PubMed

Kaneko M, Eguchi K, Ohmatsu H, Kakinuma R, Naruke T, Suemasu K, Moriyama N (1996) Peripheral lung cancer: screening and detection with low-dose spiral CT versus radiography. Radiology 201:798–802PubMed

Sobue T, Moriyama N, Kaneko M et al (2002) Screening for lung cancer with low-dose helical computed tomography: anti-lung cancer association project. J Clin Oncol 20:911–920CrossRefPubMed

Sone S, Takashima S, Li F, Yang Z, Honda T, Maruyama Y, Hasegawa M, Yamanda T, Kubo K, Hanamura K, Asakura K (1998) Mass screening for lung cancer with mobile spiral computed tomography scanner. Lancet 351:1242–1245CrossRefPubMed

10.

Sone S, Li F, Yang Z-G et al (2001) Results of three-year mass screening programme for lung cancer using mobile low-dose spiral computed tomography scanner. Br J Cancer 84:25–32CrossRefPubMed

11.

Henschke CI, McCauley DI, Yankelevitz DF, Naidich DP, McGuinness G, Miettinen OS, Libby DM, Pasmantier MW, Koizumi J, Altorki NK, Smith JP (1999) Early lung cancer action project: overall design and findings from baseline screening. Lancet 354:99–105CrossRefPubMed

12.

Henschke CI, Naidich DP, Yankelevitz DF, McGuinness G, McCauley DI, Smith JP, Libby D, Pasmantier M, Vazquez M, Koizumi J, Flieder D, Altorki N, Miettinen OS (2001) Early lung cancer action project: initial findings on repeat screenings. Cancer 92:153–159CrossRefPubMed

13.

Swensen SJ, Jett JR, Sloan JA, Midthun DE, Hartman TE, Sykes AM, Aughenbaugh GL, Zink FE, Hillman SL, Noetzel GR, Marks RS, Clayton AC, Pairolero PC (2002) Screening for lung cancer with low-dose spiral computed tomography. Am J Respir Crit Care Med 165:508–513PubMed

14.

Diederich S, Wormanns D, Semik M, Thomas M, Lenzen H, Roos N, Heindel W (2002) Screening for early lung cancer with low-dose spiral CT: prevalence in 817 asymptomatic smokers. Radiology 222:773–781PubMed

15.

Diederich S, Thomas M, Semik M, Lenzen H, Roos N, Weber A, Heindel W, Wormanns D (2004) Screening for early lung cancer with low-dose spiral computed tomography: results of annual follow-up examinations in asymptomatic smokers. Eur Radiol 14:691–702CrossRefPubMed

16.

Nawa T, Nakagawa T, Kusano S et al (2002) Lung cancer screening using low-dose spiral CT. Chest 122:15–20CrossRefPubMed

17.

Pastorino U, Bellomi M, Landoni C, De Fiori E, Arnaldi P, Picchio M, Pelosi G, Boyle P, Fazio F (2003) Early lung-cancer detection with spiral CT and positron emission tomography in heavy smokers: 2-year results. Lancet 362:593–597CrossRefPubMed

18.

Kim YH, Lee KS, Primack SL, Kim H, Kwon OJ, Kim TS, Kim EA, Kim J, Shim YM (2002) Small pulmonary nodules on CT accompanying surgically resectable lung cancer: likelihood of malignancy. J Thorac Imaging 17:40–46CrossRefPubMed

19.

Diederich S (2003) Screening for early lung cancer with low-dose spiral computed tomography. Lancet 362:588–589CrossRefPubMed

20.

Wormanns D, Diederich S (2004) Characterization of small pulmonary nodules by CT. Eur Radiol 14:1380–1391PubMed

21.

Swensen SJ, Viggiano RW, Midthun DE, Muller NL, Sherrick A, Yamashita K, Naidich DP, Patz EF, Hartman TE, Muhm JR, Weaver AL (2000) Lung nodule enhancement at CT: multicenter study. Radiology 214:73–80PubMed

22.

Yankelevitz DF, Henschke CI (1997) Does 2-year stability imply that pulmonary nodules are benign? Am J Roentgenol 168:325–328

23.

Bankoff MS, McEniff NJ, Bhadelia RA, Garcia-Moliner M, Daly BD (1996) Prevalence of pathologically proven intrapulmonary lymph nodes and their appearance on CT. Am J Roentgenol 167:629–630

24.

Sykes AM, Swensen SJ, Tazelaar HD, Jung SH (2002) Computed tomography of benign intrapulmonary lymph nodes: retrospective comparison with sarcoma metastases. Mayo Clin Proc 77:329–333PubMed

25.

Matsuki M, Noma S, Kuroda Y, Oida K, Shindo T, Kobayashi Y (2001) Thin-section CT features of intrapulmonary lymph nodes. J Comput Assist Tomogr 25:753–756CrossRefPubMed

Title: Resolving small pulmonary nodules: CT features
Authors: S. Diederich
J. Hansen
D. Wormanns
Publication date: 01-10-2005
Publisher: Springer-Verlag
Published in: European Radiology / Issue 10/2005
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-005-2836-4

At a glance: The STEP trials

Springer Medicine

Resolving small pulmonary nodules: CT features

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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