ArticleInsights into imaging2023
Differentiation of pulmonary solid nodules attached to the pleura detected by thin-section CT.
Article in Insights into imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 7 citations in OpenAlex.
- Incidence and risk factors for malignancy in patients with incidental solitary pulmonary nodules: a systematic review and meta-analysis.Annals of medicine · 2026Pooled it
- Risk factors for malignant solid pulmonary nodules: a meta-analysis.BMC cancer · 2025Pooled it
- Associations between CT characteristics of lung cancer lesions and histologic subtypes in lung cancer screening.European radiology · 2026Article
- Predicting Invasiveness of Lung Adenocarcinoma from Chest CT with Few-shot Vision-Language Ternary Classification Model.NPJ digital medicine · 2025Article
- Exploring the key clinical and CT characteristics of granulomas mimicking peripheral lung cancers: a case-control study.Insights into imaging · 2025Article
- Significance of the Lesion-Pleura Relationship in Differentiating Peripheral Inflammatory Lesions and Lung Cancers.Journal of inflammation research · 2025Article
- Clinical and radiological characteristics of Mpox pneumonia in immunosuppressed HIV-infected patients: a multicenter study from China.Frontiers in microbiology · 2025Article
- Diagnostic utility and limitations of CT-guided transthoracic fine-needle aspiration biopsy in Lung-RADS 4 pulmonary nodules ≤2 cm.Annals of Saudi medicineArticle
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPulmonary solid pleura-attached nodules (SPANs) are not very commonly detected and thus not well studied and understood. This study aimed to identify the clinical and CT characteristics for differentiating benign and malignant SPANs.
resultsFrom January 2017 to March 2023, a total of 295 patients with 300 SPANs (128 benign and 172 malignant) were retrospectively enrolled. Between benign and malignant SPANs, there were significant differences in patients' age, smoking history, clinical symptoms, CT features, nodule-pleura interface, adjacent pleural change, peripheral concomitant lesions, and lymph node enlargement. Multivariate analysis revealed that smoking history (odds ratio [OR], 2.016; 95% confidence interval [CI], 1.037-3.919; p = 0.039), abutting the mediastinal pleura (OR, 3.325; 95% CI, 1.235-8.949; p = 0.017), nodule diameter (> 15.6 mm) (OR, 2.266; 95% CI, 1.161-4.423; p = 0.016), lobulation (OR, 8.922; 95% CI, 4.567-17.431; p < 0.001), narrow basement to pleura (OR, 6.035; 95% CI, 2.847-12.795; p < 0.001), and simultaneous hilar and mediastinal lymph nodule enlargement (OR, 4.971; 95% CI, 1.526-16.198; p = 0.008) were independent predictors of malignant SPANs, and the area under the curve (AUC) of this model was 0.890 (sensitivity, 82.0%, specificity, 77.3%) (p < 0.001).
conclusionIn patients with a smoking history, SPANs abutting the mediastinal pleura, having larger size (> 15.6 mm in diameter), lobulation, narrow basement, or simultaneous hilar and mediastinal lymph nodule enlargement are more likely to be malignant. CRITICAL RELEVANCE STATEMENT: The benign and malignant SPANs have significant differences in clinical and CT features. Understanding the differences between benign and malignant SPANs is helpful for selecting the high-risk ones and avoiding unnecessary surgical resection. KEY POINTS: • The solid pleura-attached nodules (SPANs) are closely related to the pleura. • Relationship between nodule and pleura and pleural changes are important for differentiating SPANs. • Benign SPANs frequently have broad pleural thickening or embed in thickened pleura. • Smoking history and lesions abutting the mediastinal pleura are indicators of malignant SPANs. • Malignant SPANs usually have larger diameters, lobulation signs, narrow basements, and lymphadenopathy.
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