Correlation between CT imaging characteristics and pathological diagnosis for subcentimeter pulmonary nodules

• Published in: Thoracic cancer Vol. 13; no. 7; pp. 1067 - 1075
• Main Authors: Hu, Benchuang, Ren, Wangang, Feng, Zhen, Li, Meng, Li, Xiao, Han, Rui, Peng, Zhongmin
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.04.2022; John Wiley & Sons, Inc; Wiley
• Subjects: adenocarcinoma; Adenocarcinoma of Lung - pathology; Blood vessels; computed tomography imaging; histopathology; Humans; Lung cancer; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - surgery; morphological; Morphology; Multiple Pulmonary Nodules - diagnostic imaging; Multiple Pulmonary Nodules - pathology; Multiple Pulmonary Nodules - surgery; Original; Retrospective Studies; Statistical analysis; subcentimeter pulmonary nodules (SCPNs); Thoracic surgery; Tomography, X-Ray Computed - methods; Variance analysis; histopathology; adenocarcinoma; computed tomography imaging; morphological; subcentimeter pulmonary nodules (SCPNs)
• ISSN: 1759-7706; 1759-7714
• DOI: 10.1111/1759-7714.14363

Background Advances in chest computed tomography (CT) have resulted in more frequent detection of subcentimeter pulmonary nodules (SCPNs), some of which are non‐benign and may represent invasive lung cancer. The present study aimed to explore the correlation between pathological diagnosis and the CT imaging manifestations of SCPNs. Methods This retrospective study included patients who underwent pulmonary resection for SCPNs at Shandong Provincial Hospital in China. Lesions were divided into five categories according to their morphological characteristics on CT: cotton ball, solid‐filled with spiculation, solid‐filled with smooth edges, mixed‐density ground‐glass, and vacuolar. We further analyzed lesion size, enhancement patterns, vascular aggregation, and SCPN traversing. Chi‐square tests, Fisher's exact tests, and Welch's one‐way analysis of variance were used to examine the correlation between CT imaging characteristics and pathological type. Results There were statistically significant differences in the morphological distributions of SCPNs with different pathological types, including benign lesions and malignant lesions at different stages (p < 0.01). The morphological distributions of the four subtypes of invasive lung adenocarcinoma also exhibited significant differences (p < 0.01). In addition, size and enhancement patterns differed significantly among different pathological types of SCPNs. Conclusion Different pathological types of SCPNs exhibit significant differences based on their morphological category, size, and enhancement pattern on CT imaging. These CT characteristics may assist in the qualitative diagnosis of SCPNs. Different pathological types of SCPNs exhibit significant differences based on their morphological category, size, and enhancement pattern on CT imaging. Given that most patients with SCPNs present with no clinical manifestations, these differences may be of substantial diagnostic value.