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Comparison of the Brock Model and LU-RADS in Differentiating Benign and Malignant Subsolid Pulmonary Nodules

Background The Lung Imaging Reporting and Data System (LU-RADS) and the Brock model are commonly utilized tools in clinical practice for evaluating pulmonary nodules. However, both LU-RADS and the Brock model have yet to be validated and compared specifically in subsolid pulmonary nodules (SSN). Therefor, the objective of this study was to compare the perfomance of the Brock model and LU-RADS in differentiating between malignant and benign SSN. Methods The study retrospectively analyzed the clinical data of patients diagnosed with SSN who underwent surgical resection and received pathological confirmation between January 2018 and December 2022. Based on the pathological results, the patients were categorized into two groups: benign SSN and malignant SSN. The clinical data of these groups were subjected to statistical analysis. The probability of malignancy in SSN was determined using the Brock model. Additionally, the LU-RADS category of SSN was independently determined by two radiologists. Receiver operating characteristic (ROC) curves were constructed for both the Brock model and LU-RADS, and the area under the curve (AUC) was calculated. Results A total of 133 patients with SSN were included in the study. The malignant SSN group, specifically LU-RADS category 4A and 4B, exhibited a higher prevalence compared to the benign SSN group (56 vs 4, P<0.05). Furthermore, the probability of malignancy in the malignant SSN group was significantly greater than that in the benign SSN group (0.21 vs 0.06, P<0.05). The Brock model demonstrated a strong correlation with LU-RADS (r=0.75, P<0.01) and exhibited comparable diagnostic performance in identifying lung cancer in patients with SSN (Brock vs LU-RADS, AUC: 0.83 vs 0.78, P=0.16). Subgroup analysis revealed that the Brock model displayed superior diagnostic accuracy in identifying malignancy in mixed ground glass nodules (Brock vs LU-RADS, AUC: 0.92 vs 0.85, P=0.03). However, both models demonstrated similar lower performance in detecting malignancy in pure ground glass nodules (Brock vs LU-RADS, AUC: 0.59 vs 0.55, P=0.66). Conclusion The Brock model demonstrated superior efficacy in distinguishing between malignant and benign mixed ground glass nodules, as compared to the LU-RADS. However, both the Brock model and LU-RADS exhibited limited efficacy in distinguishing between malignant and benign pure ground glass nodules.

Subsolid Pulmonary Nodules, Predictive Model, LU-RADS, Malignant Nodule

Haolei Liu, Weiyun Cao, Haifen Liu, Jun Tan, Xiang Zeng, et al. (2023). Comparison of the Brock Model and LU-RADS in Differentiating Benign and Malignant Subsolid Pulmonary Nodules. Clinical Medicine Research, 12(4), 77-81.

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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