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A Solitary Necrotizing Sarcoid Granulomatosis-like Pulmonary Lesion Possibly Associated with Propionibacterium Acnes and Mycobacterium Avium.

Intern Med 2021 Jun 12. Epub 2021 Jun 12.

Division of Pathology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Japan.

We report a case of a pulmonary necrotizing sarcoid granulomatosis (NSG)-like lesion possibly associated with coinfection of Mycobacterium avium and Propionibacterium acnes. A solitary nodule in the right middle lobe of the lung was notable for coagulative necrosis with aggregates of sarcoid-like epithelioid granulomas. Small arteries were damaged by granulomas. Read More

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Discriminating Small-Sized (2 cm or Less), Noncalcified, Solitary Pulmonary Tuberculoma and Solid Lung Adenocarcinoma in Tuberculosis-Endemic Areas.

Diagnostics (Basel) 2021 May 21;11(6). Epub 2021 May 21.

Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, China.

Background: Pulmonary tuberculoma can mimic lung malignancy and thereby pose a diagnostic dilemma to clinicians. The purpose of this study was to establish an accurate, convenient, and clinically practical model for distinguishing small-sized, noncalcified, solitary pulmonary tuberculoma from solid lung adenocarcinoma.

Methods: Thirty-one patients with noncalcified, solitary tuberculoma and 30 patients with solid adenocarcinoma were enrolled. Read More

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CT Findings of Pulmonary Metastases from Primary Cardiac Angiosarcoma.

Curr Med Imaging 2021 May 21. Epub 2021 May 21.

Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Background: Primary cardiac angiosarcoma is a rare malignancy with high predilection to involve surrounding structures such as pulmonary metastases. We analysed the chest computed tomography (CT) imaging features of patients diagnosed with primary cardiac angiosarcoma with pulmonary metastases in this study.

Methods: This study retrospectively reviewed 12 patients with confirmed primary cardiac angiosarcoma, out of which eight (all men) with pulmonary metastasis were included in the analysis. Read More

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Incidental Lung Nodules on Cross-sectional Imaging: Current Reporting and Management.

Radiol Clin North Am 2021 Jul;59(4):535-549

Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, Center for Biomedical Imaging, 660 First Avenue, New York, NY 10016, USA.

Pulmonary nodules are the most common incidental finding in the chest, particularly on computed tomographs that include a portion or all of the chest, and may be encountered more frequently with increasing utilization of cross-sectional imaging. Established guidelines address the reporting and management of incidental pulmonary nodules, both solid and subsolid, synthesizing nodule and patient features to distinguish benign nodules from those of potential clinical consequence. Standard nodule assessment is essential for the accurate reporting of nodule size, attenuation, and morphology, all features with varying risk implications and thus management recommendations. Read More

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A case report of primary pulmonary meningioma masquerading as lung metastasis in a patient with rectal carcinoma: role of F-FDG PET/CT.

J Cardiothorac Surg 2021 May 29;16(1):153. Epub 2021 May 29.

Ningbo PET/CT center, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.

Background: Primary pulmonary meningioma (PPM) is an extremely rare disease, which is often misdiagnosed as lung metastasis. Previous studies indicated that PPM usually showed homogeneous enhancement on enhanced CT and high uptake of F-fluorodeoxyglucose (F-FDG) on positron emission tomography/CT (PET/CT). In this study, we report a case of PPM with atypical enhanced CT and F-FDG PET/CT features in a patient with rectal carcinoma. Read More

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The value of various peritumoral radiomic features in differentiating the invasiveness of adenocarcinoma manifesting as ground-glass nodules.

Eur Radiol 2021 May 26. Epub 2021 May 26.

Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China.

Objectives: To evaluate the ability of CT radiomic features extracted from peritumoral parenchyma of 2 mm and 5 mm distinguishing invasive adenocarcinoma (IAC) from adenocarcinoma in situ (AIS)/minimally invasive adenocarcinoma (MIA).

Methods: For this retrospective study, 121 lung adenocarcinomas appearing as ground-glass nodules on thin-section CT were evaluated. Quantitative radiomic features were extracted from the peritumoral parenchymal region of 2 mm and 5 mm on CT imaging, and the radiomic models of External2 and External5 were constructed. Read More

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Strategies for the Management of Solitary Pulmonary Nodules. A Survey of Patient Preferences.

Ann Thorac Surg 2021 May 22. Epub 2021 May 22.

Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Victoria, 3050, Australia; Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Medical Oncology and Haematology, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia.

Background: Guideline-based strategies for evaluation of solitary pulmonary nodules are tailored to the likelihood of malignancy. Surveillance, biopsy or resection are all reasonable approaches in fit individuals when the likelihood of malignancy is intermediate. Given the paucity of data demonstrating superior outcomes and important trade-offs between strategies, guidelines emphasize the importance of eliciting patient preferences and engaging in shared decision-making, however there is little literature on what patient preferences actually are. Read More

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Automatic classification of solitary pulmonary nodules in PET/CT imaging employing transfer learning techniques.

Med Biol Eng Comput 2021 Jun 18;59(6):1299-1310. Epub 2021 May 18.

Department of Medical Physics, School of Medicine, University of Patras, 26504, Patras, Greece.

Early and automatic diagnosis of Solitary Pulmonary Nodules (SPN) in Computed Tomography (CT) chest scans can provide early treatment for patients with lung cancer, as well as doctor liberation from time-consuming procedures. The purpose of this study is the automatic and reliable characterization of SPNs in CT scans extracted from Positron Emission Tomography and Computer Tomography (PET/CT) system. To achieve the aforementioned task, Deep Learning with Convolutional Neural Networks (CNN) is applied. Read More

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[Lung cancer screening with low dose computed tomography : a systematic review].

Rev Mal Respir 2021 May 11;38(5):489-505. Epub 2021 May 11.

Département des soins intensifs & urgences oncologiques et clinique d'oncologie thoracique, institut Jules-Bordet, Rue Héger-Bordet 1, 1000 Bruxelles, Belgique.

Introduction: Bronchial cancer, often diagnosed at a late stage, is the leading cause of cancer death. As early detection could potentially lead to curative treatment, several studies have evaluated low-dose chest CT (LDCT) as a screening method. The main objective of this work is to determine the impact of LDCT screening on overall mortality of a smoking population. Read More

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[Surgical Cases of Solitary Lesion after Surgery for Primary Lung Cancer].

Kyobu Geka 2021 May;74(5):331-335

Department of Thoracic Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Lung nodules during postoperative follow-up of lung cancer are generally suspected to be its recurrence, but some cases are diagnosed as non-malignant disease. From January 2001 to November 2018, we experienced 5( 4.5%) new non-malignant lesions in 112 lung cancer patients who underwent a lung resection. Read More

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Type A thymoma with simultaneous solitary intrapulmonary metastasis: A case report.

Thorac Cancer 2021 Jun 7;12(12):1923-1926. Epub 2021 May 7.

Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.

A 79-year-old woman was referred to our facility because of an abnormal chest shadow. Chest computed tomography (CT) showed a solitary right middle lung nodule with a maximum diameter of 3 mm and anterior mediastinal nodule with a maximum diameter of 21 mm. The lung nodule was suspected of being a primary lung cancer rather than a metastatic tumor because there were no primary malignant tumors, apart from an anterior mediastinal tumor visible on diagnostic imaging, including F fluorodeoxyglucose-positron emission tomography, and a solitary lung nodule. Read More

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A simplified cluster model and a tool adapted for collaborative labeling of lung cancer CT scans.

Comput Methods Programs Biomed 2021 Jul 18;206:106111. Epub 2021 Apr 18.

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department, Petrovka str., 24, Moscow, 127051, Russia; Federal Research Center "Computer Science and Control" of Russian Academy of Sciences, Vavilova str., 44/2, Moscow, 119333, Russia. Electronic address:

Background And Objective: Lung cancer is the most common type of cancer with a high mortality rate. Early detection using medical imaging is critically important for the long-term survival of the patients. Computer-aided diagnosis (CAD) tools can potentially reduce the number of incorrect interpretations of medical image data by radiologists. Read More

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Proposing a deep learning-based method for improving the diagnostic certainty of pulmonary nodules in CT scan of chest.

Eur Radiol 2021 May 6. Epub 2021 May 6.

Deepwise AI Lab, Beijing, China.

Objective: To compare the performance of a deep learning (DL)-based method for diagnosing pulmonary nodules compared with radiologists' diagnostic approach in computed tomography (CT) of the chest.

Materials And Methods: A total of 150 pathologically confirmed pulmonary nodules (60% malignant) assessed and reported by radiologists were included. CT images were processed by the proposed DL-based method to generate the probability of malignancy (0-100%), and the nodules were divided into the groups of benign (0-39. Read More

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Usefulness of dynamic fluorodeoxyglucose positron emission tomography/computed tomography in diagnosing pulmonary arteriovenous malformation mimicking a lung tumour.

Interact Cardiovasc Thorac Surg 2021 May 5. Epub 2021 May 5.

Department of Chest Disease, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey.

A 61-year-old male patient with known kidney dysfunction who underwent a non-contrast thorax CT and was then referred to our department for metabolic assessment of solitary pulmonary nodule (SPN). The patient underwent dynamic FDG PET/CT to differentiate benign from malignant SPN. This case illustrates the usefulness of dynamic FDG PET/CT imaging when assessing SPN especially in patients with suspicion for pulmonary arterio-venous malformation accompanying renal failure or contrast allergy. Read More

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Isolated Solitary Lung Nodule in a Patient With Idiopathic Pulmonary Fibrosis and Concomitant Prostate Cancer: A Challenging Diagnosis.

Cureus 2021 Mar 31;13(3):e14218. Epub 2021 Mar 31.

Department of Respiratory Medicine, National Coordinating Reference Centre for Rare Pulmonary Diseases, Louis Pradel Hospital, University Hospital of Lyon, Lyon, FRA.

Prostate cancer is the most commonly diagnosed malignancy and the second most common cause of death in men after lung cancer. Isolated pulmonary metastasis from prostate cancer, without bone or lymph node involvement, is rare and accounts for less than 1% of cases. The diagnosis of solitary lung metastasis is even more challenging in patients with concomitant pulmonary disease and often mandates tissue biopsy from the lung nodule. Read More

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A New Outlook on the Ability to Accumulate an Iodine Contrast Agent in Solid Lung Tumors Based on Virtual Monochromatic Images in Dual Energy Computed Tomography (DECT): Analysis in Two Phases of Contrast Enhancement.

J Clin Med 2021 Apr 26;10(9). Epub 2021 Apr 26.

Department of Internal Medicine, Pulmonology, Allergy and Clinical Immunology, Military Institute of Medicine, Szaserów 128, 04-141 Warsaw, Poland.

For some time, dual energy computed tomography (DECT) has been an established method used in a vast array of clinical applications, including lung nodule assessment. The aim of this study was to analyze (using monochromatic DECT images) how the X-ray absorption of solitary pulmonary nodules (SPNs) depends on the iodine contrast agent and when X-ray absorption is no longer dependent on the accumulated contrast agent. Sixty-six patients with diagnosed solid lung tumors underwent DECT scans in the late arterial phase (AP) and venous phase (VP) between January 2017 and June 2018. Read More

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Pre-Processing Method for Contouring the Uptake Levels of [18F] FDG for Enhanced Specificity of PET Imaging of Solitary Hypermetabolic Pulmonary Nodules.

J Clin Med 2021 Apr 1;10(7). Epub 2021 Apr 1.

Department of Nuclear Medicine, Medical University of Bialystok, M. Skłodowskiej-Curie St. 24A, 15-276 Bialystok, Poland.

Background: The paper presents a pre-processing method which, based on positron-emission tomography (PET) images of F-fluorodeoxyglucose ([18F] FDG) hypermetabolic pulmonary nodules, makes it possible to obtain additional visual characteristics and use them to enhance the specificity of imaging.

Material And Methods: A retrospective analysis of 69 FDG-PET/CT scans of solitary hypermetabolic pulmonary nodules (40 cases of lung cancer and 29 benign tumours), where in each case, the standardised uptake value of the hottest voxel within the defined volume of interest was greater than 2.5 (SUVmax > 2. Read More

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Prediction efficacy of feature classification of solitary pulmonary nodules based on CT radiomics.

Eur J Radiol 2021 Jun 18;139:109667. Epub 2021 Mar 18.

Department of Radiology, The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, 223300, China. Electronic address:

Objective: To investigate the relationship between CT radiomic features, pathological classification of pulmonary nodules, and evaluate the prediction effect of different stratified progressive radiomic models on the pathological classification of pulmonary nodules.

Methods: Altogether, 189 patients pathologically confirmed with pulmonary nodules from July 2017 to August 2019 who had complete data were enrolled, including 71 patients with benign nodules, 51 with malignant non-invasive nodules, and 67 with invasive nodules. Three CT radiomic models were established respectively. Read More

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CT-Guided Microcoil Localization of Small Peripheral Pulmonary Nodules to Direct Video-Assisted Thoracoscopic Resection without the Aid of Intraoperative Fluoroscopy.

Korean J Radiol 2021 Apr 1. Epub 2021 Apr 1.

Department of Radiology, China-Japan Friendship Hospital, Beijing, China.

Objective: To evaluate the feasibility, safety, and effectiveness of CT-guided microcoil localization of solitary pulmonary nodules (SPNs) for guiding video-assisted thoracoscopic surgery (VATS).

Materials And Methods: Between June 2016 and October 2019, 454 consecutive patients with 501 SPNs who received CT-guided microcoil localization before VATS in our institution were enrolled. The diameter of the nodules was 0. Read More

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Understanding the patient journey to diagnosis of lung cancer.

BMC Cancer 2021 Apr 14;21(1):402. Epub 2021 Apr 14.

Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 1900, New Orleans, LA, 70112, USA.

Objective: This research describes the clinical pathway and characteristics of two cohorts of patients. The first cohort consists of patients with a confirmed diagnosis of lung cancer while the second consists of patients with a solitary pulmonary nodule (SPN) and no evidence of lung cancer. Linked data from an electronic medical record and the Louisiana Tumor Registry were used in this investigation. Read More

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Preoperative computed tomography-guided localization of lung nodules with needle placement: a series of cases.

Rev Col Bras Cir 2021 9;48:e20202890. Epub 2021 Apr 9.

- Hospital Nossa Senhora das Graças, Serviço de Cirurgia Torácica - Curitiba - PR - Brasil.

Objective: to report the preoperative localization of pulmonary nodules with the placement of a guidewire oriented by Computed Tomography.

Methods: the nodules were marked using a needle in the shape of a hook or another in the shape of a Q, guided by tomography. The choice of the location for the marking was the shortest distance from the chest wall to the nodule. Read More

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Prone position [F]FDG PET/CT to reduce respiratory motion artefacts in the evaluation of lung nodules.

Eur Radiol 2021 Apr 14. Epub 2021 Apr 14.

Department of Radiology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul, 07441, Republic of Korea.

Objectives: 2-Deoxy-2-[F]fluoro-D-glucose ([F]FDG) positron-emission tomography/computed tomography (PET/CT) is widely used to evaluate lung nodules, although respiratory motion artefacts may occur. We investigated the value of prone position PET/CT (pPET/CT) in lung nodule evaluation compared with standard supine position PET/CT (sPET/CT).

Methods: We retrospectively reviewed 28 consecutive patients (20 men; age, 65. Read More

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Thyroid tuberculosis.

Indian J Tuberc 2021 Apr 12;68(2):272-278. Epub 2020 Sep 12.

Department of General Surgery, Dr Ram Manohar Lohia Hospital and Post Graduate, Institute of Medical Education and Research, New Delhi, India. Electronic address:

Thyroid tuberculosis is a rare disease. Its incidence is low even in countries where prevalence of pulmonary tuberculosis is high (0.1-0. Read More

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A solitary pulmonary nodule caused by Mycobacterium tuberculosis var. BCG after intravesical BCG treatment: a case report.

BMC Pulm Med 2021 Apr 7;21(1):115. Epub 2021 Apr 7.

Department of Respiratory Medicine and Infectious Diseases, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan.

Background: Intravesical instillation of bacillus Calmette-Guérin (BCG) as a treatment for superficial bladder cancer rarely causes pulmonary complications. While published cases have been pathologically characterized by multiple granulomatous lesions due to disseminated infection, no case presenting as a solitary pulmonary nodule has been reported.

Case Presentation: A man in his 70 s was treated with intravesical BCG for early-stage bladder cancer. Read More

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What Effect Do Pulmonary Micronodules Detected at Presentation in Patients with Osteosarcoma Have on 5-Year Overall Survival?

J Clin Med 2021 Mar 15;10(6). Epub 2021 Mar 15.

Rush University Medical College, Chicago, IL 60612, USA.

For osteosarcoma, staging criteria, prognosis estimates, and surgical recommendations have not yet changed to reflect increasingly sensitive computed tomography (CT) imaging. However, the frequent identification of micronodules (<5 mm) on presentation leaves clinicians in a difficult position regarding the need to biopsy, resect, or follow the lesions and whether to consider the patient metastatic or non-metastatic. Our objective was to compare the 5-year overall survival rates of patients with osteosarcoma with non-surgically resected lung micronodules on presentation to patients without micronodules to guide community oncologists faced with this common dilemma. Read More

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Is the Yedikule-solitary pulmonary nodule malignancy risk score sufficient to predict malignancy? An internal validation study.

Interact Cardiovasc Thorac Surg 2021 Apr 1. Epub 2021 Apr 1.

Department of Thoracic Surgery, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.

Objectives: We aimed to develop a malignancy risk score model for solitary pulmonary nodules (SPNs) using the demographic, radiological and clinical characteristics of patients in our centre. The model was then internally validated for malignancy risk estimation.

Methods: A total of 270 consecutive patients who underwent surgery for SPN between June 2017 and May 2019 were retrospectively analysed. Read More

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Diagnostic accuracy of visual analysis versus dual time-point imaging with F-FDG PET/CT for the characterization of indeterminate pulmonary nodules with low uptake.

Rev Esp Med Nucl Imagen Mol (Engl Ed) 2021 May-Jun;40(3):155-160. Epub 2021 Mar 27.

Departamento de Medicina Nuclear, Clínica Universidad de Navarra, Pamplona, España.

Objective: To determine the accuracy of visual analysis and the retention index (RI) with dual-time point F-FDG PET/CT for the characterization of indeterminate pulmonary nodules (IPN) with low FDG uptake.

Materials And Methods: A retrospective analysis was performed on 43 patients (28 men, 64 ± 11 years old, range 36-83 years) referred for IPN characterization with F-FDG-PET/CT and maximum standard uptake value ≤ 2.5 at 60 minutes post-injection (SUV). Read More

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Trans-scapular approach coil localization for scapular-blocked pulmonary nodules: a retrospective study.

J Cardiothorac Surg 2021 Mar 25;16(1):55. Epub 2021 Mar 25.

Department of Radiology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China.

Background: Preoperative computed tomography (CT)-guided coil localization (CL) is commonly used to facilitate video-assisted thoracoscopic surgery (VATS)-guided diagnostic wedge resection (WR) of pulmonary nodules (PNs). When a scapular-blocked PN (SBPN) is localized, the trans-scapular CL (TSCL) is commonly performed. In this study, we investigated the safety, feasibility, and clinical efficacy of preoperative CT-guided TSCL for SBPNs. Read More

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Lung adenocarcinoma mimicking hamartoma on CT.

Diagn Interv Imaging 2021 Mar 18. Epub 2021 Mar 18.

Department of Radiology, Hôpital Cochin, AP-HP centre, 75014 Paris, France; Université de Paris, 75006 Paris, France. Electronic address:

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Interobserver variability in Lung CT Screening Reporting and Data System categorisation in subsolid nodule-enriched lung cancer screening CTs.

Eur Radiol 2021 Mar 17. Epub 2021 Mar 17.

Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam-si, Gyeongi-do, 13620, Korea.

Objectives: To assess interobserver agreement in Lung CT Screening Reporting and Data System (Lung-RADS) categorisation in subsolid nodule-enriched low-dose screening CTs.

Methods: A retrospective review of low-dose screening CT reports from 2013 to 2017 using keyword searches for subsolid nodules identified 54 baseline CT scans. With an additional 108 negative screening CT scans, a total of 162 CT scans were categorised according to the Lung-RADS by two fellowship-trained thoracic radiologists in consensus. Read More

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