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Semi-automated segmentation software measured the mean diameter, volume, and overall mean CT attenuation (m-CTA) of all nodules. Nodule mass, diameter, volume, and mass doubling time were further calculated. Based on follow-up results, nodules were divided into cancer and non-cancer groups to compare growth rates and identify the optimal method for detecting malignancy-related growth. All SSNs were further divided into growth and non-growth groups based on selected measurements for comparison of clinical and radiological features. Independent predictors of SSN growth were evaluated through Kaplan-Meier analysis and Multivariate Cox regression modeling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In both datasets, significant differences (p\u2009&lt;\u20090.05) were identified in all quantitative parameters including diameter, volume and mass between the cancer and non-cancer groups. Volume and its doubling time demonstrated the smallest P-values (p\u2009&lt;\u20090.001), indicating that volumetric assessment provides the most sensitive measurement for detecting tumor growth. Multivariable Cox regression analysis showed that age, pleural indentation, and initial m-CTA were independent risk factors for the growth of SSNs in both datasets (all p\u2009&lt;\u20090.05), while nodule type was significantly associated with growth only in the NLST dataset (p\u2009&lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Advanced age, pleural indentation sign, and a higher initial m-CTA attenuation are independent risk factors for the growth of SSNs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12880-026-02694-5","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:25:56Z","timestamp":1787243156000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of risk factors in persistent subsolid pulmonary nodules based on CT dynamic follow-up"],"prefix":"10.1186","volume":"26","author":[{"given":"Fei","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinlong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangyang","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shenyu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanbo","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaman","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufang","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2122-5490","authenticated-orcid":false,"given":"Xiaopeng","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"issue":"1","key":"2694_CR1","first-page":"47","volume":"4","author":"B Han","year":"2024","unstructured":"Han B, Zheng R, Zeng H, et al. 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