CT Findings of Persistent Pure Ground Glass Opacity: Can We Predict the Invasiveness?

  • Liu, Li-Heng (Department of Radiology, Shandong Cancer Hospital and Institute) ;
  • Liu, Ming (Department of Radiation Oncology, Shandong Cancer Hospital and Institute, School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences) ;
  • Wei, Ran (Department of Radiology, Jining No.1 People's Hospital) ;
  • Jin, Er-Hu (Department of Radiology, Capital Medical University, Beijing Friendship Hospital) ;
  • Liu, Yu-Hui (Department of Radiology, Shandong Cancer Hospital and Institute) ;
  • Xu, Liang (Department of Radiology, Shandong Cancer Hospital and Institute) ;
  • Li, Wen-Wu (Department of Radiology, Shandong Cancer Hospital and Institute) ;
  • Huang, Yong (Department of Radiology, Shandong Cancer Hospital and Institute)
  • Published : 2015.03.18


Background: To investigate whether CT findings can predict the invasiveness of persistent cancerous pure ground glass opacity (pGGO) by correlating the CT imaging features of persistent pGGO with pathological changes. Materials and Methods: Ninety five patients with persistent pGGOs were included. Three radiologists evaluated the morphologic features of these pGGOs at high resolution CT (HRCT). Binary logistic regression was used to assess the association between CT findings and histopathological classification (pre-invasive and invasive groups). Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of diameters. Results: A total of 105 pGGOs were identified. Between pre-invasive (atypical adenomatous hyperplasia, AAH, and adenocarcinoma in situ, AIS) and invasive group (minimally invasive adenocarcinoma, MIA and invasive lung adenocarcinomas, ILA), there were significant differences in diameter, spiculation and vessel dilatation (p<0.05). No difference was found in air-bronchogram, bubble-lucency, lobulated-margin, pleural indentation or vascular convergence (p>0.05). The optimal threshold value of the diameters to predict the invasiveness of pGGO was 12.50mm. Conclusions: HRCT features can predict the invasiveness of persistent pGGO. The pGGO with a diameter more than 12.50mm, presences of spiculation and vessel dilatation are important factors to differentiate invasive adenocarcinoma from pre-invasive cancerous lesions.



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