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Yoon, Jin, Han, and Kim: CT Findings of Solitary Pulmonary Nodules Less than 8 mm to Differentiate the Malignant and Benign
Chest Radiology
Journal of the Korean Society of Radiology

Journal of the Korean Society of Radiology 2013; 68(2): 99-106.

Published online: 15 February 2013

DOI: https://doi.org/10.3348/jksr.2013.68.2.99

CT Findings of Solitary Pulmonary Nodules Less than 8 mm to Differentiate the Malignant and Benign

Ki Woong Yoon, MD1, Gong Yong Jin, MD1, Young Min Han, MD1, Eun Young Kim, MD2

1Department of Radiology, Chonbuk National University Medical School and Hospital, Institute of Medical Science, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.

2Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Corresponding author: Gong Yong Jin, MD. Department of Radiology, Chonbuk National University Medical School and Hospital, Institute of Medical Science, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju 561-712, Korea. Tel. 82-63-250-2307, Fax. 82-63-272-0481, gyjin@chonbuk.ac.kr

Received 18 September 2012       Accepted 11 November 2012

Copyright © 2013 The Korean Society of Radiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We assessed CT features of the solitary pulmonary nodules (SPNs) smaller than 8 mm to evaluate the differences between the benign and malignant nodules.

Materials and Methods

The study included 113 patients (66 male, 47 female, age range: 33-79 years) with SPNs smaller than 8 mm. Mean diameter of SPN on CT was 4.95 ± 1.19 cm; benign, 4.91 ± 1.24 mm; and malignant, 6.09 ± 1.01 mm. Of the 113 nodules, there were 23 (20.4%) malignant nodules and 90 (79.6%) benign nodules. The CT findings (size, shape, margin, density) of SPNs were analyzed. The statistical differences of the malignant and benign nodules were analyzed by χ2 test.

Results

The differences of the benign and malignant nodules were in the margin and density. In the margins, spiculation and lobulation occurred with a significantly higher frequency in the malignant nodules (spiculated: 10/23, lobulated: 7/23) than the benign nodules (spiculated: 20/90, lobulated: 0/90) (p < 0.001). In the mixed or pure ground glass attenuation (14/23), the malignancy rates were significantly higher than the solid nodules (p < 0.001). In the mixed and pure attenuation, a lobulated or spiculated margin (12/14) was associated with a higher risk of malignancy (p = 0.005).

Conclusion

In smaller than 8 mm nodules, the predictive CT findings of malignancy were spiculated or lobulated margin and mixed or pure attenuation.

Keywords: Lung Neoplasms, Solitary Pulmonary Nodule, Multidetector Computed Tomography

Figures and Tables

Fig. 1
Bronchioloalveolar cell carcinoma in a 39-year-old man. Non-contrast CT with lung setting shows a 7 mm sized subsolid nodule with the spiculated mixed ground-glass attenuation in the right lower lobe.
jksr-68-99-g001
Fig. 2
Bronchioloalveolar cell carcinoma in a 37-year-old woman. Non-contrast CT with lung setting shows a 7 mm sized pure ground-glass attenuation nodule with lobulated margin.
jksr-68-99-g002
Fig. 3
Anthracotic pigmentation in a 69-year-old man. Non-contrast CT with lung setting shows a 4.5 mm sized solid nodule with smooth margin.
jksr-68-99-g003
Fig. 4
Adenocarcinoma in situ, non-mucinous type in a 50-year-old man. Non-contrast CT with lung setting shows a 5 mm sized pure ground-glass attenuation nodule with lobulated margin.
jksr-68-99-g004
Table 1
Pathologic Subtypes of Total 113 Solitary Pulmonary Nodules
jksr-68-99-i001

Datas in parentheses are percentage.

Table 2
Morphologic Features between Benign and Malignant Pulmonary Nodules Smaller than 8 mm
jksr-68-99-i002

Datas in parentheses are percentages.

Note.-GGA = ground glass attenuation

Table 3
Margin Characteristics of Subsolid Pulmonary Nodules
jksr-68-99-i003

Datas in parentheses are percentages.

Table 4
Mean Sensitivity, Specificity, and Accuracy of Significant Imaging Findings and Combinations of Findings in Benign Nodules Less than 5 mm
jksr-68-99-i004

Datas in parentheses are percentages.

Table 5
Morphologic Features between Benign and Malignant Pulmonary Nodules in 5-8 mm
jksr-68-99-i005

Datas in parentheses are percentages.

Note.-GGA = ground glass attenuation

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