Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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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
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Abstract

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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References

  1. Cho S, Yang H, Kim K, et al (2013). Pathology and prognosis of persistent stable pure ground-glass opacity nodules after surgical resection. Ann Thorac Surg, 96, 1190-5. https://doi.org/10.1016/j.athoracsur.2013.05.062
  2. Eisenberg RL, Bankier AA, Boiselle PM (2010). Compliance with fleischner society guidelines for management of small lung nodules: a survey of 834 radiologists. Radiology, 255, 218-24. https://doi.org/10.1148/radiol.09091556
  3. Garfield DH, Cadranel JL, Wislez M, et al (2006). The bronchioloalveolar carcinoma and peripheral adenocarcinoma spectrum of diseases. J Thorac Oncol, 1, 344-59. https://doi.org/10.1097/01243894-200605000-00014
  4. Jiang B, Takashima S, Miyake C, et al (2014). Thin-section CT findings in peripheral lung cancer of 3 cm or smaller: are there any characteristic features for predicting tumor histology or do they depend only on tumor size? Acta Radiol, 55, 302-8. https://doi.org/10.1177/0284185113495834
  5. Kim HY, Shim YM, Lee KS, et al (2007). Persistent pulmonary nodular ground-glass opacity at thin-section CT: histopathologic comparisons. Radiology, 245, 267-75. https://doi.org/10.1148/radiol.2451061682
  6. Lee HY, Choi YL, Lee KS, et al (2014). Pure ground-glass opacity neoplastic lung nodules: histopathology, imaging, and management. AJR Am J Roentgenol, 202, 224-33. https://doi.org/10.2214/AJR.13.11819
  7. Lee HY, Lee KS (2011). Ground-glass opacity nodules: histopathology, imaging evaluation, and clinical implications. J Thorac Imaging, 26, 106-18. https://doi.org/10.1097/RTI.0b013e3181fbaa64
  8. Lim HJ, Ahn S, Lee KS, et al (2013). Persistent pure ground-glass opacity lung nodules >/= 10 mm in diameter at CT scan: histopathologic comparisons and prognostic implications. Chest, 144, 1291-9. https://doi.org/10.1378/chest.12-2987
  9. Naidich DP, Bankier AA, MacMahon H, et al (2013). Recommendations for the management of subsolid pulmonary nodules detected at CT: a statement from the fleischner society. Radiology, 266, 304-17. https://doi.org/10.1148/radiol.12120628
  10. Oda S, Awai K, Liu D, et al (2008). Ground-glass opacities on thin-section helical CT: differentiation between bronchioloalveolar carcinoma and atypical adenomatous hyperplasia. AJR Am J Roentgenol, 190, 1363-8. https://doi.org/10.2214/AJR.07.3101
  11. Travis WD, Brambilla E, Noguchi M, et al (2011). International association for the study of lung cancer/American thoracic society/European respiratory society: international multidisciplinary classification of lung adenocarcinoma: executive summary. Proc Am Thorac Soc, 8, 381-5. https://doi.org/10.1513/pats.201107-042ST
  12. Xing Y, Li Z, Jiang S, et al (2014). Analysis of pre-invasive lung adenocarcinoma lesions on thin-section computerized tomography. Clin Respir J, [Epub ahead of print]

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