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Correlation between CT growth patterns and invasiveness progression in neoplastic subcentimeter sub-solid nodules.

Ting Li¹, Can Ding¹, Shan-Tong Yan¹

¹Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Annals of Medicine

|December 8, 2025

Summary

Subcentimeter neoplastic sub-solid nodules (SSNs) showing size growth, particularly with increased attenuation, suggest a higher risk of invasiveness. Tumor mass is the key predictor for progression to invasive adenocarcinoma and invasive lesions.

Keywords:

Adenocarcinoma computed tomography follow-up studies sub-solid nodules

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Area of Science:

Pulmonary Medicine
Radiology
Oncology

Background:

Sub-solid nodules (SSNs) growth patterns can indicate invasiveness.
Understanding these patterns is crucial for early detection and management of lung cancer.

Purpose of the Study:

To clarify the correlation between growth patterns (size and attenuation) and invasiveness progression in subcentimeter neoplastic SSNs.
To identify key CT indicators for predicting invasiveness progression.

Main Methods:

Retrospective analysis of 629 neoplastic SSNs (<10 mm) from 530 patients.
Lesions categorized into four groups based on CT changes over ≥3 months: no growth, size and attenuation growth, size-only growth, attenuation-only growth.
Pathological results correlated with growth patterns to determine CT indicators of invasiveness progression.

Main Results:

Invasive adenocarcinomas (IACs) and invasive lesions (ILs) were significantly more prevalent in nodules with both size and attenuation growth (Groups II) and size-only growth (Group III) compared to no growth (Group I).
Nodules with attenuation-only growth (Group IV) showed no significant increase in IACs or ILs compared to Group I.
Tumor mass was a more effective predictor for progression to IAC and ILs in Groups II and III.

Conclusions:

Size growth, especially with concurrent attenuation increase, in subcentimeter SSNs indicates a higher possibility of invasiveness progression.
Tumor mass is the primary CT indicator for predicting invasiveness progression in these nodules.