Role of quantitative computed tomography texture analysis in the differentiation of primary lung cancer and granulomatous nodules

A solitary pulmonary nodule (SPN) is defined as a rounded opacity measuring up to 3.0 cm and surrounded by lung parenchyma (1). With the increasing use of multidetector computed tomography (MDCT) to investigate respiratory symptoms, the detection of a solitary nodule is a frequent incidental finding on chest imaging. In the CT screening setting of high-risk populations, up to 75% of screened individuals have a nodule detected over a multiyear screening process (2). At least one nodule is detected in up to 51% of initial screening CT’s (3) and approximately 20% of these nodules will require further investigation (4,5) even though over 95% of these will ultimately prove to be benign on the basis of further imaging, long-term follow-up, or invasive procedures (4-6)