ArticleQuantitative imaging in medicine and surgery2026
Natural history and clinical characteristics of pulmonary subsolid nodules in pediatric patients: a cohort study.
Article in Quantitative imaging in medicine and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The management of subsolid nodules (SSNs) in children and adolescents remains controversial. The aim of this study was clarifying the natural history of SSNs in the pediatric patient population and generate insights into the effective follow-up of these nodules. Methods: Patients aged 18 years or younger admitted to a tertiary medical center from July 2010 to June 2025 with persistent SSNs on computed tomography (CT) scans but no extrapulmonary malignancy were retrospectively enrolled and assessed. Retrospective recruitment was performed in September 2025. The data analyzed included the incidence of interval growth; clinical, radiologic, and pathological features; and follow-up outcomes of the SSNs. Results: A total of 105 patients (52 females) comprising 141 SSNs [including 137 pure ground-glass nodules (PGGNs) and four part-solid nodules (PSNs)] were analyzed and evaluated. The median follow-up time was 23 months [interquartile range (IQR), 13-36 months]. Of the 141 SSNs, 5 (4%) (3 PGGNs and 2 PSNs) exhibited interval growth. One PSN demonstrated an increase in solid components, was surgically resected, and was pathologically confirmed to be minimally invasive adenocarcinoma (MIA). One PGGN and one PSN exhibited an increase in nodule size, and the PSN was confirmed to be invasive adenocarcinoma (IVA). Two PGGNs grew a small solid component, and one of them was MIA. The interval from initial CT examination to growth in these five SSNs was 12, 17, 20, 37, and 98 months. Ten SSNs (eight PGGNs and two PSNs) in nine stable individuals underwent pulmonary resection, including one IVA, seven MIAs, and two adenocarcinomas in situ. One PGGN underwent microwave ablation. Conclusions: Persistent SSNs in pediatric patients should not be overlooked. Approximately 4% of persistent SSNs in children and adolescents showed subsequent growth in our study. The findings suggest that longer interval surveillance may be valuable in pediatric patients, particularly for reducing unnecessary radiation exposure, and management should be performed on an individualized basis.
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