From a clinical point of view, this means that by using the 1D method, measurement values <1.32 and <1.73 mm cannot be distinguished from errors. The pathologist will determine if the nodule is cancerous. Differences in volume estimation have been reported when using different software and different algorithms of correction of partial volume effect artefacts [57, 67, 116–118]. Since the increase in the detection rate of small pulmonary nodules, the clinical significance of these findings represents a new challenge [2, 4], and the optimal management of each case becomes pivotal and should be conducted according to the clinical setting. The radiologists indicated which nodules were suspicious and that they would hence raise the Lung-RADS category to 4X. When considering size for managing an indeterminate pulmonary nodule the existence of a potential inherent inaccuracy of nodule measurements in terms of diameter, volume and growth rate should be taken into account. Whether a thing is big or small depends on what it is, what it's doing there, whether it's growing or sh ... Read More. 1: Walsh SLF. When your lung nodule is considered highly suspicious based on its size, shape and appearance on chest x-ray or CT scan and your history of smoking and family history of lung cancer, it will need to be biopsied to determine if it is cancerous. 8 mm or larger 2. 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By using semi-automated/automated methods the ROI is defined automatically or by starting from a point inside the nodule selected by the user. In PSNs, Lee et al. 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In fact, experts estimate that about half of Americans will have one by the time they’re 60 years old. Although most are benign, ∼10%-15% prove malignant. Lung nodules are very common, especially in people who have smoked, but not all lung nodules mean lung cancer; there are many possible causes. The performance of 1D and 2D measurements depends mainly on nodule size, technical conditions and reading setting. In addition, major technical concerns exist regarding nodule volumetry during follow-up. The biopsy is a simple procedure of getting a sample from the pulmonary nodule for microscopic exam. Baaklini et al. The study demonstrated that by using a multivariate model, when follow-up data are available, nodule growth assessed by VDT at 1-year follow-up was the only strong predictor for malignancy. Secondly, volume measurement methods tend to be more susceptible to the influence of technical parameters and software type used to perform volumetry. 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