title: Significance of pulmonary nodules in patients with colorectal cancer.
abstract: OBJECTIVE
  Radiographically small pulmonary nodules (PNs) in patients with colorectal cancer are troublesome because their discovery raises concern about metastases. This study sought to establish the appropriate timing of radiological follow-up for PNs detected at initial staging evaluation of colorectal carcinoma patients.
  
  
  METHODS
  The medical records of 376 consecutive colorectal cancer patients who underwent curative surgery and had baseline and follow-up chest X-rays (CXR) and computed tomography (CT) were reviewed.
  
  
  RESULTS
  The study included 92 patients who had all CXR and chest CT available for review, at least one PN found on baseline imaging, and no synchronous neoplasms. On baseline chest CT, these 92 patients had 170 PNs altogether and 77 (45.2 %) of them were greater than 5 mm in size. Baseline CXR detected 13 PNs in 12 patients and all but 2 were larger than 5 mm. Nodule size greater than 5 mm and irregular margins were predictors of nodule growth. The mean doubling time of 24/170 (14.1 %) growing PNs was about 4 months.
  
  
  CONCLUSIONS
  Our findings suggest that baseline and follow-up CXR are pointless, and short-interval CT follow-up is warranted when PNs larger than 5 mm with irregular margins are detected on preoperative chest CT.
  
  
  CONCLUSIONS
  • Pulmonary nodules in colorectal cancer patients raise concern about metastasis. • Baseline and follow-up chest X-ray in colorectal cancer can be abandoned. • CT is the best technique for assessing PNs in colorectal cancer. • Short-interval CT follow-up advisable for PNs larger than 5 mm with irregular margins.
authors.affiliation: Oncological Radiology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy. fabio.pomerri@unipd.it
authors.forename: Fabio
authors.initials: F
authors.lastname: Pomerri
authors.forename: Salvatore
authors.initials: S
authors.lastname: Pucciarelli
authors.forename: Isacco
authors.initials: I
authors.lastname: Maretto
authors.forename: Ernesta
authors.initials: E
authors.lastname: Perrone
authors.forename: Giovanna
authors.initials: G
authors.lastname: Pintacuda
authors.forename: Sara
authors.initials: S
authors.lastname: Lonardi
authors.forename: Donato
authors.initials: D
authors.lastname: Nitti
authors.forename: Pier Carlo
authors.initials: PC
authors.lastname: Muzzio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000150:complications* / Q000000981:diagnostic imaging*; D015179:Colorectal Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D013902:Radiography, Thoracic / Q000379:methods; D003074:Solitary Pulmonary Nodule / Q000150:complications* / Q000000981:diagnostic imaging*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods