Subsolid pulmonary nodule morphology and associated patient characteristics in a routine clinical population

Eur Radiol. 2017 Feb;27(2):689-696. doi: 10.1007/s00330-016-4429-9. Epub 2016 Jun 2.


Objectives: To determine the presence and morphology of subsolid pulmonary nodules (SSNs) in a non-screening setting and relate them to clinical and patient characteristics.

Methods: A total of 16,890 reports of clinically obtained chest CT (06/2011 to 11/2014, single-centre) were searched describing an SSN. Subjects with a visually confirmed SSN and at least two thin-slice CTs were included. Nodule volumes were measured. Progression was defined as volume increase exceeding the software interscan variation. Nodule morphology, location, and patient characteristics were evaluated.

Results: Fifteen transient and 74 persistent SSNs were included (median follow-up 19.6 [8.3-36.8] months). Subjects with an SSN were slightly older than those without (62 vs. 58 years; p = 0.01), but no gender predilection was found. SSNs were mostly located in the upper lobes. Women showed significantly more often persistent lesions than men (94 % vs. 69 %; p = 0.002). Part-solid lesions were larger (1638 vs. 383 mm3; p < 0.001) and more often progressive (68 % vs. 38 %; p = 0.02), compared to pure ground-glass nodules. Progressive SSNs were rare under the age of 50 years. Logistic regression analysis did not identify additional nodule parameters of future progression, apart from part-solid nature.

Conclusions: This study confirms previously reported characteristics of SSNs and associated factors in a European, routine clinical population.

Key points: • SSNs in women are significantly more often persistent compared to men. • SSN persistence is not associated with age or prior malignancy. • The majority of (persistent) SSNs are located in the upper lung lobes. • A part-solid nature is associated with future nodule growth. • Progressive solitary SSNs are rare under the age of 50 years.

Keywords: Adenocarcinoma; Computed tomography; Disease management; Ground-glass; Solitary pulmonary nodule.

MeSH terms

  • Age Factors
  • Aged
  • Europe
  • Female
  • Humans
  • Lung / diagnostic imaging
  • Lung / pathology
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Sex Factors
  • Solitary Pulmonary Nodule / diagnostic imaging*
  • Solitary Pulmonary Nodule / pathology
  • Tomography, X-Ray Computed*