Small Solitary Pulmonary Nodules (≤1 cm) Detected at Population-Based CT Screening for Lung Cancer: Reliable High-Resolution CT Features of Benign Lesions

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Abstract
OBJECTIVE. We assessed thin-section CT features specific to benignity in solitary pulmonary nodules of 1 cm or smaller that were detected at population-based CT screening for lung cancer.MATERIALS AND METHODS. Two reviewers independently made qualitative (presence or absence of lobulation, spiculation, air bronchogram, cavity, satellite lesions, pleural tag, concave margins, polygonal shape, and peripheral subpleural lesion) and quantitative (lesion size, percentage of ground-glass opacity areas, and two- and three-dimensional ratios of lesion) assessments in CT images of 72 nodules (25 lung cancers, seven atypical adenomatous hyperplasias, and 40 benign lesions). Optimal criteria specific to benignity were studied.RESULTS. The prevalence of polygonal shape (p = 0.005 and p = 0.019, reviewer 1 and reviewer 2), peripheral subpleural lesion (p = 0.011 and p = 0.033), a predominantly solid lesion (p < 0.001 and p < 0.001), and three-dimensional ratios (p < 0.001 and p < 0.001) were greater in benign lesions ...