Related Experiment Video
Updated: Feb 23, 2026
Author Spotlight: A 3D Digital Model for the Diagnosis and Treatment of Pulmonary Nodules
Published on: May 19, 2023
Frequency and characteristics of pulmonary nodules in children at computed tomography
Atia Samim1, Annemieke S Littooij2, Marry M van den Heuvel-Eibrink3
1Department of Radiology, University Medical Centre Utrecht/Wilhelmina Children's Hospital, HP E01.132, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
Insights
Small pulmonary nodules are common in healthy children, but their detection and characterization on CT scans show moderate agreement among radiologists. This finding impacts care decisions for pediatric patients with cancer.
Area of Science:
- Pediatric Radiology
- Thoracic Imaging
- Medical Diagnostics
Background:
- Normative data for pulmonary nodules in healthy children are scarce.
- Understanding nodule prevalence and characteristics is crucial for managing pediatric cancer patients.
Purpose of the Study:
- To establish normative data for pulmonary nodule frequency and characteristics.
- To analyze nodules detected via computed tomography (CT) in young children.
Main Methods:
- Retrospective analysis of chest CT scans in children aged 1-12 years post-trauma.
- Exclusion of patients with malignancy, motion artifacts, or extensive trauma.
- Independent nodule identification and characterization by two radiologists, with adjudication by a third for reference standard.
Main Results:
- Pulmonary nodules were found in 38% of 72 included children (median age 8 years).
- A total of 59 nodules (mean diameter 3.2 mm) were identified.
- Interobserver agreement for nodule detection was substantial (κ=0.78), but moderate for characterization (κ=0.36-0.74).
Conclusions:
- Small pulmonary nodules are frequently observed in otherwise healthy children on CT scans.
- Moderate interobserver agreement exists for nodule detection and characterization, highlighting potential variability in interpretation.
Background:
Normative data on pulmonary nodules in children without malignancy are limited. Knowledge of the frequency and characteristics of pulmonary nodules in healthy children can influence care decisions in children with malignant disease.
Objective:
To provide normative data concerning the frequency and characteristics of pulmonary nodules on computed tomography (CT) in young children.
Materials And Methods:
All children ages 1 year-12 years who underwent chest CT after high-energy trauma were retrospectively investigated. Exclusion criteria were a history of malignancy, thick image slices, motion artefacts and extensive post-traumatic pulmonary changes. Two radiologists were asked to independently identify all nodules and to characterize each nodule with respect to location, size, perifissural location and calcification. Discrepancies were adjudicated by a third reader, who set the reference standard in this study. Interobserver agreement in detection and characterization was assessed using the kappa coefficient (κ).
Results:
Identified were 120 patients, of whom 72 (75% male; median age: 8.0 years [interquartile range: 4-11]) were included. A total of 59 pulmonary nodules were present in 27 patients (38%; 95% confidence interval: 26-49%; range: 1-5 nodules per patient, with a mean diameter of 3.2 mm [standard deviation: 0.9 mm]). For nodule detection, the per-patient interobserver agreement was substantial (κ=0.78) and per-lobe agreement was moderate (κ=0.40). For characterization, there was fair to substantial agreement (κ=0.36-0.74).
Conclusion:
Small pulmonary nodules on chest CT are a common finding in otherwise healthy children, but detection and characterization have only moderate interobserver agreement.
Related Concept Videos
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
01:30Radiological Investigation I: X-ray and CT
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...
01:27Imaging Studies III: Computed Tomography