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What Causes Change In Lung Nodule Size?
Question: Hi,
I have just had a follow-up Cat Scan for 3 small lung nodules that were found last year. Each one measured 0.5cm. Good news is that in this latest test the results say that they are all stable and are compatible with scars. My question is that the size of the nodules in the latest report have changed a little (very little) - Two are now 1mm smaller and 1 is 1mm larger.
Is this size fluctuation normal even though they are "Stable"? is it due to a slight different image? Or what would cause that?
I have just had a follow-up Cat Scan for 3 small lung nodules that were found last year. Each one measured 0.5cm. Good news is that in this latest test the results say that they are all stable and are compatible with scars. My question is that the size of the nodules in the latest report have changed a little (very little) - Two are now 1mm smaller and 1 is 1mm larger.
Is this size fluctuation normal even though they are "Stable"? is it due to a slight different image? Or what would cause that?
Brief Answer:
Due to variability in measureemt
Detailed Answer:
Hi XXXX
Thanks for writing in.
I have read through your query in detail.
In my professional experience I have come across many patients who have similar findings on CT scan as you. When reporting nodules we try to take the largest diameter and on occasions this may differ by a mm or two on the higher or lower side due to the image or the radiologist measuring it. This is due to slight variabilities in the image and not significant from the clinical point of view. This certainly can be described as a stable nodule.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Due to variability in measureemt
Detailed Answer:
Hi XXXX
Thanks for writing in.
I have read through your query in detail.
In my professional experience I have come across many patients who have similar findings on CT scan as you. When reporting nodules we try to take the largest diameter and on occasions this may differ by a mm or two on the higher or lower side due to the image or the radiologist measuring it. This is due to slight variabilities in the image and not significant from the clinical point of view. This certainly can be described as a stable nodule.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for your reply!
The radiologist said that they are compatible with scar and flat. So that seems good? But do scars change in size over 6 months. Not just the one that got 1mm bigger but also the 2 that got a tiny bit smaller? Or again is this due to the imaging accuracy or the radiologist reading the image?
The radiologist said that they are compatible with scar and flat. So that seems good? But do scars change in size over 6 months. Not just the one that got 1mm bigger but also the 2 that got a tiny bit smaller? Or again is this due to the imaging accuracy or the radiologist reading the image?
Brief Answer:
Please find detailed answer below
Detailed Answer:
Hi XXXX
Thanks for writing in with an update.
The differences in measurement are surely due to not so accurate placement of calipers used while interpreting the images. I mean even the same radiologist may give 1 mm difference (larger or smaller) when reporting images on a follow up scan. This may partly also be due to the exact slice acquisition and breath hold during the CT scan.
I assure you that there is no need to worry regarding the measurements.
Wishing you good health.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find detailed answer below
Detailed Answer:
Hi XXXX
Thanks for writing in with an update.
The differences in measurement are surely due to not so accurate placement of calipers used while interpreting the images. I mean even the same radiologist may give 1 mm difference (larger or smaller) when reporting images on a follow up scan. This may partly also be due to the exact slice acquisition and breath hold during the CT scan.
I assure you that there is no need to worry regarding the measurements.
Wishing you good health.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks again and thanks for your quick response! Sorry for worrying but I had been waiting 6 months to get the results :-) Based on my follow-up results and the fact of my age and that I am low risk, would you suggest another follow-up in a year's times or not? I understand they use the Fleischner protocol. I as understand it sound like these are just old scar tissue.
Brief Answer:
Please find detailed answer below
Detailed Answer:
Hi XXXX
Thanks for writing in with an update.
As with the Fleischner protocol, nodules less than 4 mm in diameter in a low risk patient require no follow up. The same in a possibly high risk patient may be followed up after 12 months. As you are most likely in the low risk group and your follow up CT scan chest shows no significant changes, I dont think there is any immediate need to follow up in the near future. A chest X ray may be done after a year from date of detection in case you are really worried. I suggest a chest X ray as the radiation is much lesser when compared to a CT scan chest. It is indeed an area of old scar like tissue.
Wishing you good health.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find detailed answer below
Detailed Answer:
Hi XXXX
Thanks for writing in with an update.
As with the Fleischner protocol, nodules less than 4 mm in diameter in a low risk patient require no follow up. The same in a possibly high risk patient may be followed up after 12 months. As you are most likely in the low risk group and your follow up CT scan chest shows no significant changes, I dont think there is any immediate need to follow up in the near future. A chest X ray may be done after a year from date of detection in case you are really worried. I suggest a chest X ray as the radiation is much lesser when compared to a CT scan chest. It is indeed an area of old scar like tissue.
Wishing you good health.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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