title: CT Imaging Features in the Characterization of Non-Growing Solid Pulmonary Nodules in Non-Smokers.
abstract: BACKGROUND
  A disappearing or persistent solid pulmonary nodule is a neglected clinical entity that still poses serious interpretative issues to date. Traditional knowledge deriving from previous reports suggests particular features, such as smooth edges or regular shape, to be significantly associated with benignity. A large number of benign nodules are reported among smokers in lung cancer screening programmes. The aim of this single-center retrospective study was to correlate specific imaging features to verify if traditional knowledge as well as more recent acquisitions regarding benign SPNs can be considered reliable in a current case series of nodules collected in a non-smoker cohort of patients.
  
  
  METHODS
  Fifty-three solid SPNs proven as non-growing during follow-up imaging were analyzed with regard to their imaging features at thin-section CT, their predicted malignancy risk according to three major risk assessment models, minimum density analysis and contrast enhanced-CT in the relative subgroups of nodules which underwent such tests.
  
  
  RESULTS
  Eleven nodules disappeared during follow-up, 29 showed volume loss and 16 had a VDT of 1121 days or higher. There were 48 nodules located peripherally (85.71%). Evaluation of the enhancement after contrast media (n=29) showed mean enhancement ±SD of 25.72±35.03 HU, median of 18 HU, ranging from 0 to 190 HU. Minimum density assessment (n=30) showed mean minimum HU ±SD of -28.27±47.86 HU, median of -25 HU, ranging from -144 to 68 HU. Mean malignancy risk ±SD was 15.05±26.69% for the BIMC model, 17.22±19.00% for the Mayo Clinic model and 19.07±33.16% for the Gurney's model.
  
  
  CONCLUSIONS
  Our analysis suggests caution in using traditional knowledge when dealing with current small solid peripheral indeterminate SPNs and highlights how quantitative growth at follow-up should be the cornerstone of characterization.
authors.affiliation: Department of Radiology, Azienda Ospedaliera Universitaria Integrata (AOUI) Verona, Verona, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Perandini
authors.affiliation: Department of Radiology, Azienda Ospedaliera Universitaria Integrata (AOUI) Verona, Verona, Italy.
authors.forename: Gian Alberto
authors.initials: GA
authors.lastname: Soardi
authors.affiliation: Department of Radiology, Azienda Ospedaliera Universitaria Integrata (AOUI) Verona, Verona, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Motton
authors.affiliation: Department of Radiology, Azienda Ospedaliera Universitaria Integrata (AOUI) Verona, Verona, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Augelli
authors.affiliation: Department of Radiology, Azienda Ospedaliera Universitaria Integrata (AOUI) Verona, Verona, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Zantedeschi
authors.affiliation: Department of Radiology, Azienda Ospedaliera Universitaria Integrata (AOUI) Verona, Verona, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Montemezzi
keywords: Lung Neoplasms; Multidetector Computed Tomography; Solitary Pulmonary Nodule