Solitary Pulmonary Nodules: Detection, Characterization, and Guidance for Further Diagnostic Workup and Treatment

Jeong, Yu Jeong; Yi, Chin A; Lee, Kyung Soo

doi:10.2214/ajr.05.2131

Cited by 110 publications

(88 citation statements)

References 77 publications

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“…Generally speaking, typical noncalcified nodules refer to solid lesions with diameters ranging from 8 to 30 mm [26,27]. Malignant probability for the smaller ones are usually low, especially for those less than 5 mm, only about 0-1 % [27][28][29]. Accordingly, we overlooked nodules with a maximum diameter below 5 mm; but larger ones over 30 mm were considered to be positive.…”

Section: Discussionmentioning

confidence: 99%

Early Lung Cancer Detection Using the Self-Evaluation Scoring Questionnaire and Chest Digital Radiography: A 3-Year Follow-up Study in China

et al. 2012

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The standard definition of high-risk individuals for lung cancer was not uniform and the value of chest digital radiography (DR) in lung cancer screening was still unproven. The aim of this study was to assess whether the original questionnaire named as "Self-evaluation Scoring Questionnaire for High-risk Individuals of Lung Cancer" combined with DR examinations could detect early stage of lung cancer effectively. The Self-evaluation Scoring Questionnaire for High-risk Individuals of Lung Cancer had been designed in previous studies. Subjects with scores over 116 points were regarded as high-risk individuals and underwent the current DR scans at least once a year from 2007 to 2009. Noncalcified nodules with a diameter over 30 mm, along with enlarged pulmonary hilus and atelectasis, were considered to be positive and subjected to further special examinations. Efficacy of the scoring questionnaire combined with DR scans was estimated by 3-year results. Among 1,537 subjects, 13, 11, and 7 were diagnosed with lung cancer in the first, second, J Digit Imaging (2013) 26:72-81 DOI 10.1007 and third year, respectively, indicating the detection rate of 2.02 % (31/1,537). In addition, 77.42 % (24/31) of the patients were in stage I and 51.61 % (16/31) were adenocarcinomas. For the 31 cases, 28 were defined as detected cancers, while the other three were interval ones, only accounting for 0.20 % (3/1,504) of individuals with negative judgments. The protocol of Self-evaluation Scoring Questionnaire for High-risk Individuals of Lung Cancer combined with DR scans is a cost-effective and safe approach to detect early stage of lung cancer.

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Section: Discussionmentioning

confidence: 99%

Early Lung Cancer Detection Using the Self-Evaluation Scoring Questionnaire and Chest Digital Radiography: A 3-Year Follow-up Study in China

et al. 2012

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“…The characterization of SPN is a challenging and important issue, since from 2-13 % in screening studies up to 46-82 % in PET/CT studies can be malignant [3,9,10]. The current gold standard is pathology, unfeasible in many cases and carrying risks [10] difficult to be justified in subjects with a low probability of cancer.…”

Section: Diagnostic Imaging In Spnmentioning

confidence: 99%

Segmental 18F-FDG-PET/CT in a single pulmonary nodule: a better cost/effectiveness strategy

Spadafora

Pace

Mansi

2016

Eur J Nucl Med Mol Imaging

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“…Small solitary pulmonary nodules are likely to be benign. A screening study by Henschke et al in 2004 found that none of the detected malignancies were less than 5 mm in diameter [10] The prevalence of malignancy correlates with nodule size (0% -1% for nodules/5 mm, 6% -28% for nodules 5 -10 mm, 33% -60% for nodules 11 -20 mm, and 64% -82% for nodules greater than 20 mm) [9] [13].…”

Section: Sizementioning

confidence: 99%

“…Depending on the appearance and radiologic context, certain SPNs are judged sufficiently typical of benign masses that follow-up is not warranted. Important factors that suggest benignity is the presence of characteristic calcification, the presence of fat with the SPN, the size, rate of growth certain characteristics such as SPN margins [10].…”

Section: Introductionmentioning

confidence: 99%

Differentiation of Benign and Malignant Solitary Pulmonary Nodule: Literature Review

Tripathi¹,

Zhen²

2015

ALC

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The solitary pulmonary nodule (SPN) is frequently seen on chest radiographs and computed tomography (CT), usually the identification is accidental. The overall prevalence of malignancy is relatively low but identification of malignancy of nodule is of prime importance. There are different characters of nodules indicating malignancy, and also the exposure of person to risk factors increases the chances of malignancy of nodule. Chances of malignancy rise with increasing size, the irregular, lobulated border of the nodules is highly associated with higher probability of malignancy and nodules with pure ground grass appearance have higher probability of malignancy, irregularly marginated nodule displaying a corona radiata sign indicating neoplastic infiltration with distortion of neighbouring tissue is almost certainly a malignant nodule. Stippled, punctuate, and eccentric calcifications are suggestive of malignancy. There are 20% -75% of chances of malignancy if nodule is appeared with ground-glass opacity. Malignant nodules have higher growth rate as compared with benign nodules, malignant nodules usually have doubling time (DT) of 30 -400 days while DT of more than 450 days is sign of benignity whereas doubling time less than 30 days is usually acute infectious process. The presence of fat within nodule is sign of benignity. Increasing density of the nodule is suggestive of malignancy and requires shorter follow up. Besides the nodule evaluation the chances of malignancy can also be evaluated through the exposure of patient to risk factors like age, current and past smoking status and history of extra thoracic malignancy. The management depends upon various factors mainly three strategies are applied for management including careful observation of nodule, use of diagnostic techniques like CT FNA, PET, and broncoscopy and surgery.

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Solitary Pulmonary Nodules: Detection, Characterization, and Guidance for Further Diagnostic Workup and Treatment

Cited by 110 publications

References 77 publications

Early Lung Cancer Detection Using the Self-Evaluation Scoring Questionnaire and Chest Digital Radiography: A 3-Year Follow-up Study in China

Early Lung Cancer Detection Using the Self-Evaluation Scoring Questionnaire and Chest Digital Radiography: A 3-Year Follow-up Study in China

Segmental 18F-FDG-PET/CT in a single pulmonary nodule: a better cost/effectiveness strategy

Differentiation of Benign and Malignant Solitary Pulmonary Nodule: Literature Review

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