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Long term follow-up for small pure ground-glass nodules: implications of determining an optimum follow-up period and high-resolution CT findings to predict the growth of nodules

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Abstract

Purpose

To identify the optimum follow-up period for pure ground-glass nodules (GGN) measuring less than 15 mm in diameter, and to evaluate whether the initial HRCT findings can be used as predictors for the progression of pure GGN.

Materials and methods

A total of 150 pure GGNs present in 111 patients were evaluated. The series of HRCT images for each GGN at the time of the initial detection, 2 years after detection, and at the final follow-up were evaluated. The HRCT findings of GGN were compared between the “increasing nodule” and “non-increasing nodule” groups.

Results

Most (87.3%) pure GGN did not increase whereas some nodules (12.7%) eventually increased after long-term follow-up (mean 66.0 ± 25.0 months). Six (31.6%) out of the 19 increasing nodules were regarded as stable at the 2 year follow-up examination. Some morphological findings on initial HRCT, including a size greater than 10 mm (p = 0.001), lobulated margins (p = 0.015), and a bubble-like appearance (p = 0.002), were significantly associated with the growth of pure GGNs.

Conclusion

More than 2 years of follow-up are necessary to detect the growth of pure GGNs. Some characteristic findings indicated a high likelihood of future growth of the GGN.

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Acknowledgments

We thank Dr Hossain Mahbub and Professor Noriaki Harada, Department of Hygiene, Yamaguchi University Graduate School of Medicine, for checking the results from statistical analysis published in this paper.

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Authors and Affiliations

  1. Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan

    Shotaro Takahashi, Nobuyuki Tanaka, Tomoaki Okimoto, Yoshie Kunihiro & Naofumi Matsunaga

  2. First Department of Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan

    Toshiki Tanaka & Kazuhiro Ueda

  3. Department of Imaging Diagnosis, Yamaguchi-Ube Medical Center, Ube, Yamaguchi, Japan

    Tsuneo Matsumoto

  4. Clinical Oncology Center, Nagasaki University Hospital, Nagasaki, Japan

    Kazuto Ashizawa

  5. Applied Medical Engineering Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan

    Shoji Kido

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  1. Shotaro Takahashi
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Correspondence to Shotaro Takahashi.

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Takahashi, S., Tanaka, N., Okimoto, T. et al. Long term follow-up for small pure ground-glass nodules: implications of determining an optimum follow-up period and high-resolution CT findings to predict the growth of nodules. Jpn J Radiol 30, 206–217 (2012). https://doi.org/10.1007/s11604-011-0033-8

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  • DOI: https://doi.org/10.1007/s11604-011-0033-8

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