Abstract
BackgroundThe computed tomography (CT) features of small solid lung cancers and their changing regularity as they grow have not been well studied. The purpose of this study was to analyze the CT features of solid lung cancerous nodules (SLCNs) with different sizes and their variations.MethodsBetween February 2013 and April 2018, a consecutive cohort of 224 patients (225 nodules) with confirmed primary SLCNs was enrolled. The nodules were divided into four groups based on tumor diameter (A: diameter ≤ 1.0 cm, 35 lesions; B: 1.0 cm < diameter ≤ 1.5 cm, 60 lesions; C: 1.5 cm < diameter ≤ 2.0 cm, 63 lesions; and D: 2.0 cm < diameter ≤ 3.0 cm, 67 lesions). CT features of nodules within each group were summarized and compared.ResultsMost nodules in different groups were located in upper lobes (groups A − D:50.8%–73.1%) and had a gap from the pleura (groups A − D:89.6%–100%). The main CT features of smaller (diameter ≤ 1 cm) and larger (diameter > 1 cm) nodules were significantly different. As nodule diameter increased, more lesions showed a regular shape, homogeneous density, clear but coarse tumor–lung interface, lobulation, spiculation, spinous protuberance, vascular convergence, pleural retraction, bronchial truncation, and beam-shaped opacity (p < 0.05 for all). The presence of halo sign in all groups was similar (17.5%–22.5%; p > 0.05).ConclusionsThe CT features vary among SLCNs with different sizes. Understanding their changing regularity is helpful for identifying smaller suspicious malignant nodules and early determining their nature in follow-up.
Highlights
The computed tomography (CT) features of small solid lung cancers and their changing regularity as they grow have not been well studied
Several studies have been conducted on the differential diagnosis of benign and malignant subsolid nodules [4,5,6,7,8] and the solid ones [9,10,11,12,13]
Among the various CT features, spiculation, lobulation, vascular convergence, and pleural retraction have been associated with malignancy in lung cancer [6, 20,21,22,23,24,25]; they are helpful in differentiating benign from malignant nodules
Summary
The computed tomography (CT) features of small solid lung cancers and their changing regularity as they grow have not been well studied. Pulmonary nodules are one of the main presentations of lung cancer; they have always been the key point of research Based on their density features on computed tomography (CT) images, cancerous nodules can be generally divided into solid and subsolid nodules, each with significantly different morphological and pathological features [3]. Among the various CT features, spiculation, lobulation, vascular convergence, and pleural retraction have been associated with malignancy in lung cancer [6, 20,21,22,23,24,25]; they are helpful in differentiating benign from malignant nodules These features are usually absent in smaller nodules, making their diagnosis challenging. There is no systematic report on changes other than those in size, including shape, density, margins, interface, and internal characteristics; the clinical significance of
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