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002) (exp(β)111.353 (95% confidence interval (CI) 5.960-2081), age ≥40 years (p = 0.015) (exp(β) 23.242 (95% CI 1.854-291.4)), and lymphovascular invasion (p = 0.021) (exp(β) 22.511 (95% CI 1.595-317.6)) were the only independent factors associated with aggressive SPN. Our data suggest that age ≥40 years, PET/CT Type III configuration, and lymphovascular invasion are independent factors associated with aggressive SPN. This information can help clinicians develop individualized management and surveillance plans to manage patients more e