Abstract
The incidence of indeterminate pulmonary nodules has risen constantly over the past few years. Determination of lung nodule malignancy is pivotal, because the early diagnosis of lung cancer could lead to a definitive intervention. According to the current international guidelines, size and growth rate represent the main indicators to determine the nature of a pulmonary nodule. However, there are some limitations in evaluating and characterising nodules when only their dimensions are taken into account. There is no single method for measuring nodules, and intrinsic errors, which can determine variations in nodule measurement and in growth assessment, do exist when performing measurements either manually or with automated or semi-automated methods. When considering subsolid nodules the presence and size of a solid component is the major determinant of malignancy and nodule management, as reported in the latest guidelines. Nevertheless, other nodule morphological characteristics have been associated with an increased risk of malignancy. In addition, the clinical context should not be overlooked in determining the probability of malignancy. Predictive models have been proposed as a potential means to overcome the limitations of a sized-based assessment of the malignancy risk for indeterminate pulmonary nodules.
Abstract
Size and growth rate remain the main determinants of nodule management http://ow.ly/mtDB30gugUg
Footnotes
Number 4 in the Series “Radiology” Edited by Nicola Sverzellati and Sujal Desai
Previous articles in this series: No. 1: Walsh SLF. Multidisciplinary evaluation of interstitial lung diseases: current insights. Eur Respir Rev 2017; 26: 170002. No. 2: Elicker BM, Kallianos KG, Henry TS. The role of high-resolution computed tomography in the follow-up of diffuse lung disease. Eur Respir Rev 2017; 26: 170008. No. 3: Robbie H, Daccord C, Chua F, et al. Evaluating disease severity in idiopathic pulmonary fibrosis. Eur Respir Rev 2017; 26: 170051.
Conflict of interest: None declared.
Provenance: Commissioned article, peer reviewed.
- Received March 17, 2017.
- Accepted October 28, 2017.
- Copyright ©ERS 2017.
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