Managing Persistent Subsolid Nodules in Lung Cancer: Education, Decision Making, and Impact of Interval Growth Patterns

Yung-Chi Liu; Chia-Hao Liang; Yun-Ju Wu; Chi-Shen Chen; En-Kuei Tang; Fu-Zong Wu

doi:10.3390/diagnostics13162674

Managing Persistent Subsolid Nodules in Lung Cancer: Education, Decision Making, and Impact of Interval Growth Patterns

Diagnostics (Basel). 2023 Aug 14;13(16):2674. doi: 10.3390/diagnostics13162674.

Authors

Yung-Chi Liu^{1

2

3}, Chia-Hao Liang⁴, Yun-Ju Wu^{5

6}, Chi-Shen Chen⁷, En-Kuei Tang⁸, Fu-Zong Wu^{5

9

10

11}

Affiliations

¹ Department of Radiology, Xiamen Chang Gung Hospital, Xiamen 361028, China.
² Department of Imaging Technology Division, Xiamen Chang Gung Hospital, Xiamen 361028, China.
³ Department of Healthcare Administration Department, Xiamen Chang Gung Hospital, Xiamen 361028, China.
⁴ Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei 112304, Taiwan.
⁵ Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan.
⁶ Department of Software Engineering and Management, National Kaohsiung Normal University, Kaohsiung 80201, Taiwan.
⁷ Physical Examination Center, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan.
⁸ Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan.
⁹ School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan.
¹⁰ Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan.
¹¹ Institute of Education, National Sun Yat-Sen University, Kaohsiung 804241, Taiwan.

Abstract

With the popularization of lung cancer screening, many persistent subsolid nodules (SSNs) have been identified clinically, especially in Asian non-smokers. However, many studies have found that SSNs exhibit heterogeneous growth trends during long-term follow ups. This article adopted a narrative approach to extensively review the available literature on the topic to explore the definitions, rationale, and clinical application of different interval growths of subsolid pulmonary nodule management and follow-up strategies. The development of SSN growth thresholds with different growth patterns could support clinical decision making with follow-up guidelines to reduce over- and delayed diagnoses. In conclusion, using different SSN growth thresholds could optimize the follow-up management and clinical decision making of SSNs in lung cancer screening programs. This could further reduce the lung cancer mortality rate and potential harm from overdiagnosis and over management.

Keywords: interval growth; lung cancer; overdiagnosis; subsolid nodules.

Publication types

Review

Grants and funding

This study was supported by grants from the Kaohsiung Veterans General Hospital, KSVGH112-109, KSVGH111-D02-3, Taiwan, R.O.C., MOST 109-2314-B-075B-006, and MOST 110-2314-B-075B-008.