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Original Research: Lung Cancer |

Characteristics of Subsolid Pulmonary Nodules Showing Growth During Follow-up With CT ScanningSubsolid Nodules Showing Growth During Follow-up

Haruhisa Matsuguma, MD; Kiyoshi Mori, MD; Rie Nakahara, MD; Haruko Suzuki, MD; Takashi Kasai, MD; Yukari Kamiyama, MD; Seiji Igarashi, MD; Tetsuro Kodama, MD; Kohei Yokoi, MD
Author and Funding Information

From the Divisions of Thoracic Surgery (Drs Matsuguma, Nakahara, and Suzuki), Thoracic Diseases (Drs Mori, Kasai, Kamiyama, and Kodama), and Pathology (Dr Igarashi), Tochigi Cancer Center, Utsunomiya; and Division of Thoracic Surgery (Dr Yokoi), Nagoya University Graduate School of Medicine, Nagoya, Japan.

Correspondence to: Haruhisa Matsuguma, MD, Division of Thoracic Surgery, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya, Tochigi 320-0834, Japan; e-mail: hmatsugu@tcc.pref.tochigi.lg.jp


Funding/Support: This work was supported in part by a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan, and by the second-term comprehensive 10-year strategy for cancer control.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(2):436-443. doi:10.1378/chest.11-3306
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Objective:  The positive results of a screening CT scan trial are likely to lead to an increase in the use of CT scanning, and, consequently, an increase in the detection of subsolid nodules. Noninvasive methods including follow-up with CT scanning, to determine which nodules require invasive diagnosis and surgical treatment, should be defined promptly.

Methods:  Between 2000 and 2008, from our database of > 60,000 examinations with CT scanning, we identified 174 subsolid nodules, which showed a ground-glass opacity area > 20% of the nodule and measured ≤ 2 cm in diameter, in 171 patients. We investigated the clinical characteristics and CT images of the subsolid nodules in relation to changes identified during the follow-up period.

Results:  The nodule sizes ranged from 4 mm to 20 mm at the first presentation. Nonsolid nodules numbered 98. During the follow-up period, 18 nodules showed resolution or shrinkage, and 41 showed growth of 2 mm or more in diameter. The time to 2-mm nodule-growth curves calculated by Kaplan-Meier methods indicated that the 2-year and 5-year cumulative percentages of growing nodules were 13% and 23% in patients with nonsolid nodules and 38% and 55% in patients with part-solid nodules, respectively. Multivariate analysis disclosed that a large nodule size (> 10 mm) and history of lung cancer were significant predictive factors of growth in nonsolid nodules.

Conclusions:  An effective schedule for follow-up with CT scanning for subsolid nodules should be developed according to the type of subsolid nodule, initial nodule size, and history of lung cancer.

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