CT characteristics of solid pulmonary nodules of never smokers versus smokers: A population-based study

Jiali Cai; Marleen Vonder; Marjolein A Heuvelmans; Gert Jan Pelgrim; Mieneke Rook; Gerdien Kramer; Grigory Sidorenkov; Harry J M Groen; Geertruida H de Bock; Rozemarijn Vliegenthart

doi:10.1016/j.ejrad.2022.110410

CT characteristics of solid pulmonary nodules of never smokers versus smokers: A population-based study

Eur J Radiol. 2022 Sep:154:110410. doi: 10.1016/j.ejrad.2022.110410. Epub 2022 Jun 14.

Authors

Affiliations

¹ University Medical Center Groningen, University of Groningen, Dept of Epidemiology, Groningen, the Netherlands. Electronic address: j.cai@umcg.nl.
² University Medical Center Groningen, University of Groningen, Dept of Epidemiology, Groningen, the Netherlands. Electronic address: m.vonder@umcg.nl.
³ University Medical Center Groningen, University of Groningen, Dept of Epidemiology, Groningen, the Netherlands. Electronic address: m.a.heuvelmans@umcg.nl.
⁴ University Medical Center Groningen, University of Groningen, Dept of Radiology, Groningen, the Netherlands. Electronic address: g.j.pelgrim@umcg.nl.
⁵ University Medical Center Groningen, University of Groningen, Dept of Radiology, Groningen, the Netherlands; Martini Hospital Groningen, Dept of Radiology, Groningen, the Netherlands. Electronic address: m.rook@mzh.nl.
⁶ University Medical Center Groningen, University of Groningen, Dept of Radiology, Groningen, the Netherlands; Martini Hospital Groningen, Dept of Radiology, Groningen, the Netherlands. Electronic address: g.b.g.kramer@umcg.nl.
⁷ University Medical Center Groningen, University of Groningen, Dept of Epidemiology, Groningen, the Netherlands. Electronic address: g.sidorenkov@umcg.nl.
⁸ University Medical Center Groningen, University of Groningen, Dept of Pulmonology, Groningen, the Netherlands. Electronic address: h.j.m.groen@umcg.nl.
⁹ University Medical Center Groningen, University of Groningen, Dept of Epidemiology, Groningen, the Netherlands. Electronic address: g.h.de.bock@umcg.nl.
¹⁰ University Medical Center Groningen, University of Groningen, Dept of Radiology, Groningen, the Netherlands. Electronic address: r.vliegenthart@umcg.nl.

PMID: 35777080
DOI: 10.1016/j.ejrad.2022.110410

Abstract

Purpose: Aim was to assess CT characteristics of lung nodules in never and former smokers compared to current smokers in a population-based setting.

Method: We included individuals aged 45-60 years taking part in the ImaLife (Imaging in Lifelines) study, with at least one solid lung nodule (≥30 mm³) on low-dose chest CT. Qualitative (location, shape, margin, nodule type, attached structures) and quantitative (count, diameter, volume) nodule characteristics were evaluated. Based on Fleischner criteria, 'high risk' nodules were defined. To examine the association between smoking status and nodule CT characteristics of participants, multi-level multinomial logistic regression corrected for clustering of nodules within participants was performed, where all odds ratios (aORs) were adjusted for age and sex.

Results: Overall, 1,639 individuals (median age: 55.0, IQR:50.5-58.5, 50.5% men) were included, with 42.1% never smokers, 35.3% former smokers and 22.6% current smokers. A total of 3,222 solid nodules were identified; 39.7% of individuals had multiple nodules. Nodule size, location, type and attachment were similar for never compared to current smokers. The odds of nodules with an irregular shape and irregular margin was lower in never smokers (aOR:0.64, 95 %CI:0.44-0.93; aOR:0.60, 95 %CI:0.41-0.88, respectively) and former smokers (aOR:0.61, 95 %CI:0.41-0.90; aOR:0.57, 95 %CI:0.38-0.85, respectively) compared to current smokers. The odds of a detected nodule being 'high risk' was similar for never versus current smokers (never smokers: aOR = 0.90; 95% CI:0.73-1.11).

Conclusions: CT-based characteristics of solid lung nodules in never and former smokers differed only slightly from current smokers. Among individuals with solid nodules, 'high-risk' nodules were equally common in never smokers and current smokers.

Keywords: Lung neoplasms/diagnostic imaging*; Middle aged; Multiple pulmonary nodules/diagnostic imaging; Smoking/adverse effects; Tomography; X-ray computed.

MeSH terms

Female
Humans
Logistic Models
Lung Neoplasms* / diagnostic imaging
Lung Neoplasms* / epidemiology
Male
Middle Aged
Smokers
Solitary Pulmonary Nodule* / diagnostic imaging
Solitary Pulmonary Nodule* / epidemiology
Tomography, X-Ray Computed / methods