Skip to main content

ORIGINAL RESEARCH article

Front. Oncol.
Sec. Pediatric Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1385600

Imaging features and clinical evaluation of pulmonary nodules in children

Provisionally accepted
Muheremu Dilimulati Muheremu Dilimulati Shuhua Yuan Shuhua Yuan Hejun Jiang Hejun Jiang Yahua Wang Yahua Wang Hui Ma Hui Ma Shiyu Shen Shiyu Shen Jilei Lin Jilei Lin *Jiande Chen Jiande Chen *Yong Yin Yong Yin *
  • Shanghai Children's Medical Center, Shanghai, China

The final, formatted version of the article will be published soon.

    Background: With the widespread use of computed tomography (CT), the detection rate of pulmonary nodules in children has gradually increased. Due to the lack of epidemiological evidence and clinical guideline on pulmonary nodule treatment in children, we aimed to provide a reference for clinical diagnosis and management of pediatirc pulmonary nodules. Methods: This retrospective study collected consecutive cases from April 2012 to July 2021 in the Shanghai Children's Medical Center. The sample included children with pulmonary nodules on chest CT scans and met the inclusion criteria. All patients were categorized into tumor and non-tumor groups by pre-CT clinical diagnosis.Nodule characteristics between groups were analyzed. To estabilsh a clinical assessment model for the benign versus malignant pulmonary nodules, patients who have been followed-up for three months were detected and a decision tree model was consturcted and valiadted.The sample comprised 1341 patients with an average age of 7.2±4.6 years.More than half of them (51.7%) were diagnosed with malignancies before CT scan. 48.3% were diagonised with non-tumor diseases or healthy. Compared to non-tumor group, children with tumor were more likely to have multiple nodules in both lungs, larger size and often accompanied by osteolytic or mass lesions. Based on the decision tree model, patients' history of malignancies, nodules diameter size≥5mm, and specific nodule distribution (multiple in both lungs, multiple in the right lung or solitary in the upper or middle right lobe) were important potential predictors for malignity. In the validation set, sensitivity, specificity and AUC were 0.855, 0.833 and 0.828 (95%CI: 0.712-0.909), respectively.This study conducted a clinical assessment model to differentiate benignity and malignancy of pediatric pulmonary nodules.We suggested that a nodule's diameter, distribution and patient's history of malignancies are predictable factors in benign or malignant determination.

    Keywords: Pulmonary nodule, Children, Benign and malignant differentiation, Diagnostic model, computed tomography

    Received: 13 Feb 2024; Accepted: 19 Jul 2024.

    Copyright: © 2024 Dilimulati, Yuan, Jiang, Wang, Ma, Shen, Lin, Chen and Yin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Jilei Lin, Shanghai Children's Medical Center, Shanghai, China
    Jiande Chen, Shanghai Children's Medical Center, Shanghai, China
    Yong Yin, Shanghai Children's Medical Center, Shanghai, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.