Likelihood ratios for malignancy in solitary pulmonary nodules

Characteristic	Characteristic probability		Number of patients	Likelihood ratio for malignancy*
Characteristic	Malignant nodules	Benign nodules	Number of patients	Likelihood ratio for malignancy*
Size
0-1 cm	–^¶	–^¶	1063	0.52
1.1-2 cm	–^¶	–^¶		0.74
2.1-3 cm	–^¶	–^¶		3.67
>3 cm	–^¶	–^¶		5.23
Edge (chest radiography)
Ill defined	0.71	0.28	152	2.51
Well defined, lobular	0.89	0.7		1.27
Well defined, smooth	0.11	0.3		0.36
Tomographic appearance
Malignant	0.44	0.01	238	37.2
Indeterminate	0.56	0.76		0.73
Benign	0	0.23		0
Edge (CT)
Smooth	–^¶	–^¶	903	0.3
Lobulated	–^¶	–^¶		0.74
Irregular/spicular	–^¶	–^¶		5.54
Calcification at tomography
Calcified	0	0.34	323	0
Noncalcified	1	0.66	323	1.5
Calcification at CT
in phantom (benign)	–^¶	–^¶	1041	0.01^Δ
in phantom	–^¶	–^¶	1041	2.2
Growth rate
<7 d	0	0.24	217	0
7-465 d	0.99	0.29		3.4
>465 d	0.01	0.46		0.01
Location
Upper/middle lobe	0.74	0.61	179	1.22
Lower lobe	0.26	0.39	179	0.66
Maximal cavity wall thickness
≤4 mm	0.03	0.47	123	0.07
5-15 mm	0.37	0.52		0.72
≥16 mm	0.59	0.02		37.97
Age
20-29 y	–^¶	–^¶	529	0.05
30-39 y	–^¶	–^¶		0.24
40-49 y	–^¶	–^¶		0.94
50-59 y	–^¶	–^¶		1.9
60-69 y	–^¶	–^¶		2.64
≥70 y	–^¶	–^¶		4.16
Smoking history
Never smoked	0.06	0.33	9036	0.19
Current cigarette smoker	0.58	0.26		2.27
Pipe/cigar smoker	0.08	0.08		1
Ex-cigarette smoker	0.24	0.26		0.92
Ex-pipe/cigar smoker	0.04	0.08		0.55
Hemoptysis	0.09	0.02	215	5.08
Previous malignancy	0.15	0.03	845	4.95

* The denominator of the likelihood ratio is omitted from the table for simplicity (eg, 0.52:1).
¶ A weighted likelihood ratio was estimated by combining results of studies.
Δ The standardization of the reference nodule has changed; 0.07 may be a better estimate for the likelihood ratio.

Redrawn from Gurney, JW, Radiology 1993; 186:405.

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Likelihood ratios for malignancy in solitary pulmonary nodules