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We sought to assess the reproducibility of size measurements of small lung nodules examined with low-dose thin-section computed tomography (LDTSCT).Three radiologists measured volume with a semiautomatic tool and diameters manually of 20 (equivalent diameter range, 5.3–11 mm) phantom nodules and 37 (mean diameter range, 5–8.5 mm) lung nodules in subjects undergoing LDTSCT.In phantoms, the worst 95% limits of agreement (95% LA) for volume were −3.0% and 3.0% within operator and −3.1% and 2.8% between operators. The coefficient of repeatability (CR) for diameter ranged between 0.51 and 0.67 mm within operator and the 95% LA were from −0.71 to 0.71 mm between operators. In nodules, the worst intraoperator 95% LA for volume were −14.4% and 17.6% within operator and −13.1% and 14.2% between operators. The CR for diameter ranged between 0.48 and 0.73 mm within operator and the 95% LA were from −1.16 to 1.16 mm between operators.Operator-dependent variability of size measurements of small nodules examined with LDTSCT is not negligible and should be considered in lung cancer-screening studies.