Transient part-solid nodules detected at screening thin-section CT for lung cancer: comparison with persistent part-solid nodules.
OBJECTIVE
To retrospectively investigate clinical and computed tomographic (CT) features of transient part-solid nodules (PSNs) initially detected at screening thin-section CT for lung cancer and to determine predictive factors that may differentiate transient PSNs from persistent PSNs.


METHODS
This study was approved by the institutional review board. From January 2006 to August 2008, 93 individuals with 126 PSNs were identified from among 16777 individuals who underwent chest CT. Clinical features and CT characteristics of PSNs were reviewed, and clinical and thin-section CT features were compared between transient and persistent PSNs. To identify predictive factors of transient PSNs and evaluate predictive performance, logistic regression analysis and C statistic analysis were performed.


RESULTS
Eighty-eight (69.8%) of 126 PSNs were transient. Between transient and persistent PSNs, there were significant differences (P < .05) in patient age, patient sex, risk of lung cancer, presence of eosinophilia, mode of detection, lesion size, lesion multiplicity, size of solid portion, and lesion border. Multivariate analysis revealed that young patient age, detection of the lesion at follow-up, blood eosinophilia, lesion multiplicity, large solid portion, and ill-defined border were significant (P < .05) independent predictors of transient PSNs. The performance in the discrimination of transient PSNs from persistent PSNs of the logistic regression model that incorporated both clinical and thin-section CT features was significantly higher than the performance of the models that incorporated clinical features or thin-section CT features alone.


CONCLUSIONS
A substantial proportion of PSNs detected at screening CT were transient. Transient PSNs could be predicted with high accuracy by using the features of young patient age, detection of the PSN at follow-up, blood eosinophilia, lesion multiplicity, large solid portion, and ill-defined lesion border.
Lee
Sang Min
SM
Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehangno, Jongno-gu, Seoul 110-744, Korea.
Park
Chang Min
CM
Goo
Jin Mo
JM
Lee
Chang Hyun
CH
Lee
Hyun Ju
HJ
Kim
Kwang Gi
KG
Kang
Mi-Jin
MJ
Lee
In Sun
IS
D000328:Adult; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D004802:Eosinophilia / Q000473:pathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012307:Risk Factors; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods