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Overview and Strategic Management of Subsolid Pulmonary Nodules

Godoy, Myrna C. B. MD, PhD*; Naidich, David P. MD

doi: 10.1097/RTI.0b013e31825d515b

A new classification of lung adenocarcinoma has been proposed recently—the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification. Abundant information from recent lung cancer computed tomography (CT) screening programs has increased our understanding of the strong, although imperfect, correlation between histologic findings of lung adenocarcinoma and subsolid pulmonary nodules on CT, including both “pure” ground-glass nodules (GGNs) and “part-solid” GGNs. Moreover, serial CT imaging has demonstrated stepwise progression of these nodules in a subset of patients, characterized by increase in size and density of GGNs and development of a solid component. Given the higher incidence of malignancy and the considerably lower growth rate of subsolid nodules, dedicated standardized guidelines for management of these nodules have been proposed, including long-term (≥3 y) CT follow-up using a low-dose technique. Radiologists should be familiar with the new terminology of lung adenocarcinomas and strategic management of subsolid pulmonary nodules.

*Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX

Department of Radiology, New York University Langone Medical Center, New York, NY

The authors declare no conflicts of interest.

Reprints: Myrna C. B. Godoy, MD, PhD, DI—Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1478, Houston, TX 77030 (e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.