Progressive changes in non-neoplastic ground-glass nodules on follow-up computed tomography (CT)

Area of Science:

• Pulmonology
• Radiology
• Pathology

Background:

• Non-neoplastic ground-glass nodules (GGNs) typically decrease in size or density over time.
• However, some GGNs exhibit progressive changes, potentially leading to unnecessary surgical resection.
• Understanding these progressive changes is crucial for accurate diagnosis and patient management.

Purpose of the Study:

• To investigate the characteristics and patterns of progressive changes in non-neoplastic GGNs.
• To identify imaging features that can help differentiate progressive non-neoplastic GGNs from potentially malignant lesions.
• To inform clinical decision-making regarding the follow-up and management of GGNs.

Main Methods:

• A cross-sectional study of 70 patients with pathologically confirmed non-neoplastic GGNs.
• Review of initial and follow-up chest computed tomography (CT) images to assess changes.
• Classification of progressive changes into five types based on density, size, and solid component presence.

Main Results:

• Among 35 GGNs with progressive changes, increasing size (Type II) was most common (40.0%).
• Volume doubling time (VDT) was less than 344 days in 71.4% of lesions with increasing volume.
• Ill-defined boundaries remained consistent in progressive and non-progressive GGNs (P>0.99).

Conclusions:

• Progressive changes in GGNs can be non-neoplastic.
• Rapid progression or persistent ill-defined boundaries may suggest a non-neoplastic nature.
• These findings aid in avoiding unnecessary interventions for benign GGNs.