title: Persistent pulmonary subsolid nodules with solid portions of 5 mm or smaller: Their natural course and predictors of interval growth.
abstract: OBJECTIVE
  To investigate the natural course of persistent pulmonary subsolid nodules (SSNs) with solid portions ≤5 mm and the clinico-radiological features that influence interval growth over follow-ups.
  
  
  METHODS
  From 2005 to 2013, the natural courses of 213 persistent SSNs in 213 patients were evaluated. To identify significant predictors of interval growth, Kaplan-Meier analysis and Cox proportional hazard regression analysis were performed.
  
  
  RESULTS
  Among the 213 nodules, 136 were pure ground-glass nodules (GGNs; growth, 18; stable, 118) and 77 were part-solid GGNs with solid portions ≤5 mm (growth, 24; stable, 53). For all SSNs, lung cancer history (p = 0.001), part-solid GGNs (p < 0.001), and nodule diameter (p < 0.001) were significant predictors for interval growth. On subgroup analysis, nodule diameter was an independent predictor for the interval growth of both pure GGNs (p < 0.001), and part-solid GGNs (p = 0.037). For part-solid GGNs, lung cancer history (p = 0.002) was another significant predictor of the interval growth. Interval growth of pure GGNs ≥10 mm and part-solid GGNs ≥8 mm were significantly more frequent than in pure GGNs <10 mm (p < 0.001) and part-solid GGNs <8 mm (p = 0.003), respectively.
  
  
  CONCLUSIONS
  The natural course of SSNs with solid portions ≤5 mm differed significantly according to their nodule type and nodule diameters, with which their management can be subdivided.
  
  
  CONCLUSIONS
  • Pure GGNs ≥10 mm have significantly more frequent interval growth than those <10 mm. • Part-solid GGNs ≥8 mm have significantly more frequent interval growth than those <8 mm. • Management of SSNs with solid portions ≤5 mm can be subdivided by diameter.
authors.affiliation: 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.
authors.forename: Jong Hyuk
authors.initials: JH
authors.lastname: Lee
authors.affiliation: 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. cmpark.morphius@gmail.com.|Cancer Research Institute, Seoul National University, Seoul, Korea. cmpark.morphius@gmail.com.|Department of Radiology, Duke University Medical Center, Durham, NC, USA. cmpark.morphius@gmail.com.
authors.forename: Chang Min
authors.initials: CM
authors.lastname: Park
authors.affiliation: Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Lee
authors.affiliation: 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.|Aerospace Medical Group, Air Force Education and Training Command, Jinju, Korea.
authors.forename: Hyungjin
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, NC, USA.
authors.forename: H Page
authors.initials: HP
authors.lastname: McAdams
authors.affiliation: 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.|Cancer Research Institute, Seoul National University, Seoul, Korea.
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Goo
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D065311:Adenocarcinoma in Situ / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging* / Q000473:pathology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden; D055815:Young Adult
keywords: Adenocarcinoma in situ; Computed tomography; Follow-up studies; Lung adenocarcinoma; Portion size