Seasonal prevalence and characteristics of low-dose CT detected lung nodules in a general Dutch population

Harriet L Lancaster,Maarten Van Den Berge,Mieneke Rook,Ahmed Aown,Gert Jan Pelgrim,Marjolein A Heuvelmans,Geertruida H De Bock,Marius G J Kok,Harry J M Groen,Rozemarijn Vliegenthart

doi:10.1038/s41598-021-88328-y

Harriet L Lancaster, Maarten Van Den Berge + Show 8 more

Open Access

https://doi.org/10.1038/s41598-021-88328-y

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Abstract

We investigated whether presence and characteristics of lung nodules in the general population using low-dose computed tomography (LDCT) varied by season. Imaging in Lifelines (ImaLife) study participants who underwent chest LDCT-scanning between October 2018 and October 2019 were included in this sub-study. Hay fever season (summer) was defined as 1st April to 30th September and Influenza season (winter) as 1st October to 31st March. All lung nodules with volume of ≥ 30 mm3 (approximately 3 mm in diameter) were registered. In total, 2496 lung nodules were found in 1312 (38%) of the 3456 included participants (nodules per participant ranging from 1 to 21, median 1). In summer, 711 (54%) participants had 1 or more lung nodule(s) compared to 601 (46%) participants in winter (p = 0.002). Of the spherical, perifissural and left-upper-lobe nodules, relatively more were detected in winter, whereas of the polygonal-, irregular-shaped and centrally-calcified nodules, relatively more were detected in summer. Various seasonal diseases with inflammation as underlying pathophysiology may influence presence and characteristics of lung nodules. Further investigation into underlying pathophysiology using short-term LDCT follow-up could help optimize the management strategy for CT-detected lung nodules in clinical practice.

Highlights

Computed tomography (CT)-detected lung nodules remain a challenge in clinical practice
One of the potentially influencing factors on lung nodule presence in the general population is the presence of respiratory illnesses that depend on season
We investigated if the season of year when respiratory illnesses are at their peak, are an influencing factor for the presence of low-dose computed tomography (LDCT)-detected lung nodules in a general Dutch population

Summary

Introduction

Computed tomography (CT)-detected lung nodules remain a challenge in clinical practice This is due to the difficulty in distinguishing between their varying etiologies: infection, primary lung cancer, metastasis, or hamartoma to name a few. Detection through low-dose computed tomography (LDCT) screening resulted in reduced lung cancer mortality in the US National Lung Screening T rial[2]. We investigated if the season of year when respiratory illnesses are at their peak, are an influencing factor for the presence of LDCT-detected lung nodules in a general Dutch population. Research has shown a greater number of hospitalisations due to community-acquired pneumonia during the winter than any other s eason[16] In this Imaging in Lifelines (ImaLife) sub-study, we sought to investigate whether presence and characteristics of LDCT-detected lung nodules varied by season in the general population

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