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Pediatric pulmonary nodules: current state of knowledge, AI applications, and future directions
Aki A Tanimoto1,2, Cara E Morin3,4, Andrew H Schapiro3,4
1Cincinnati Children's Hospital Medical Center, Cincinnati, United States. aki.tanimoto@cchmc.org.
Insights
Pediatric pulmonary nodules are common, appearing in healthy children and those with cancer. Current guidelines lack clarity for incidental nodule follow-up in children, necessitating further research and AI applications.
Area of Science:
- Pediatric Pulmonology
- Thoracic Imaging
- Oncology
Background:
- Pulmonary nodules are frequently found in pediatric patients, both in healthy children and those with malignancies.
- Distinguishing benign from malignant pediatric pulmonary nodules based on imaging features remains challenging.
- Existing guidelines for incidental nodule management in adults do not directly translate to pediatric populations.
Purpose of the Study:
- To review the epidemiology, histology, and imaging characteristics of pediatric pulmonary nodules.
- To discuss various causes of pulmonary nodules in children, including metastases, primary lung cancer, and benign conditions.
- To explore the emerging role of artificial intelligence in evaluating pediatric pulmonary nodules.
Main Methods:
- Literature review of pediatric pulmonary nodule research.
- Analysis of epidemiological data, histological findings, and imaging features.
- Discussion of current and potential applications of artificial intelligence (AI) in diagnosis.
Main Results:
- Pulmonary nodules in children have diverse etiologies, with metastases being common in malignant cases.
- Healthy children can also present with pulmonary nodules, complicating diagnosis.
- There is a lack of established guidelines for managing incidental pulmonary nodules in pediatric patients.
Conclusions:
- Pediatric pulmonary nodules require careful evaluation due to varied causes and diagnostic challenges.
- Development of specific guidelines for pediatric nodule follow-up is crucial.
- Artificial intelligence shows promise for improving the accuracy and efficiency of pediatric pulmonary nodule assessment.
Abstract:
Pulmonary nodules are commonly encountered in pediatric patients. While metastases make up the majority of malignant pulmonary nodules found in children, nodules are also frequently identified in healthy children. Currently, there are no definitive nodule features to differentiate benign from malignant nodules, and there are no guidelines for incidental nodule follow-up in children similar in scope to the 2017 Fleischner Society Guidelines for adults. In this review, we discuss the epidemiology, histology, and imaging findings of pulmonary nodules found in healthy children, pulmonary metastases, primary pediatric lung cancer, and other causes of pulmonary nodules in children. We also explore current applications of artificial intelligence for the evaluation of pediatric pulmonary nodules.
