Diagnosis of the Invasiveness of Lung Adenocarcinoma Manifesting As Ground Glass Opacities on High-resolution Computed Tomography

Overview

Journal Thorac Cancer

Specialties Oncology
Pulmonary Medicine

Date 2016 Jan 28

PMID 26816547

Citations 9

Authors

Haixia Mao

Kanchan Labh

Fushi Han

Sen Jiang

Yang Yang

Xiwen Sun

Affiliations

Soon will be listed here.

Abstract

Background: To explore the diagnostic method in assessing the malignancy of pulmonary adenocarcinoma characterized by ground glass opacities (GGO) on computed tomography (CT).

Methods: Preoperative CT data for preinvasive and invasive lung adenocarcinomas were analyzed retrospectively. GGO lesions that were detected on lung windows but absent using the mediastinal window were subject to adjustment of the window width, which was reduced with the fixed interval of 100 HU until the lesions were no longer evident, with a fixed mediastinal window level of 40 HU. The shape, smoking habits, size of the lesion on the lung window, and window width at which lesions disappeared were compared and receiver operating characteristic curves were used to determine the optimal cut-off of the lesion size and window width to differentiate between these invasive and preinvasive lesions.

Results: Of the 209 lung adenocarcinomas, 102 were preinvasive (25 atypical adenomatous hyperplasia and 77 adenocarcinoma in situ), while 107 were invasive (78 minimally invasive adenocarcinoma and 29 invasive adenocarcinoma). The shape, lesion size, and window width at which lesions were no longer evident differed significantly between the two groups (P < 0.05). The size of 8.9 mm and a window width of 1250 HU were the optimal cut-off to differentiate between preinvasive and invasive lesions.

Conclusion: The shape, size of the lesion, and window width on high-resolution CT may be useful in assessing the invasiveness of lung adenocarcinoma that manifests as GGO. Irregular lesions that disappear at window width <1250 HU, with a diameter of > 8.9 mm are more likely to be invasive.

Citing Articles

Correlation between CT imaging characteristics and pathological diagnosis for subcentimeter pulmonary nodules.

Hu B, Ren W, Feng Z, Li M, Li X, Han R Thorac Cancer. 2022; 13(7):1067-1075.

PMID: 35212152 PMC: 8977167. DOI: 10.1111/1759-7714.14363.

Radiomics for lung adenocarcinoma manifesting as pure ground-glass nodules: invasive prediction.

Sun Y, Li C, Jin L, Gao P, Zhao W, Ma W Eur Radiol. 2020; 30(7):3650-3659.

PMID: 32162003 PMC: 7305264. DOI: 10.1007/s00330-020-06776-y.

The Prognostic Significance of Pure Ground Glass Opacities in Lung Cancer Computed Tomographic Images.

Huang C, Wang C, Wang Y, Liu J, Bie F, Wang Y J Cancer. 2019; 10(27):6888-6895.

PMID: 31839823 PMC: 6909955. DOI: 10.7150/jca.33132.

Morphological classification of pre-invasive lesions and early-stage lung adenocarcinoma based on CT images.

Gao F, Li M, Zhang Z, Xiao L, Zhang G, Zheng X Eur Radiol. 2019; 29(10):5423-5430.

PMID: 30903336 DOI: 10.1007/s00330-019-06149-0.

Radiomic analysis of pulmonary ground-glass opacity nodules for distinction of preinvasive lesions, invasive pulmonary adenocarcinoma and minimally invasive adenocarcinoma based on quantitative texture analysis of CT.

Li W, Wang X, Zhang Y, Li X, Li Q, Ye Z Chin J Cancer Res. 2018; 30(4):415-424.

PMID: 30210221 PMC: 6129571. DOI: 10.21147/j.issn.1000-9604.2018.04.04.

References

Lee H, Goo J, Lee C, Yoo C, Kim Y, Im J . Nodular ground-glass opacities on thin-section CT: size change during follow-up and pathological results. Korean J Radiol. 2007; 8(1):22-31. PMC: 2626694. DOI: 10.3348/kjr.2007.8.1.22. View

Honda T, Kondo T, Murakami S, Saito H, Oshita F, Ito H . Radiographic and pathological analysis of small lung adenocarcinoma using the new IASLC classification. Clin Radiol. 2012; 68(1):e21-6. DOI: 10.1016/j.crad.2012.09.002. View

Okada M, Nakayama H, Okumura S, Daisaki H, Adachi S, Yoshimura M . Multicenter analysis of high-resolution computed tomography and positron emission tomography/computed tomography findings to choose therapeutic strategies for clinical stage IA lung adenocarcinoma. J Thorac Cardiovasc Surg. 2011; 141(6):1384-91. DOI: 10.1016/j.jtcvs.2011.02.007. View

Ikehara M, Saito H, Yamada K, Oshita F, Noda K, Nakayama H . Prognosis of small adenocarcinoma of the lung based on thin-section computed tomography and pathological preparations. J Comput Assist Tomogr. 2008; 32(3):426-31. DOI: 10.1097/RCT.0b013e31811edc93. View

Kitami A, Kamio Y, Hayashi S, Suzuki K, Uematsu S, Gen R . One-dimensional mean computed tomography value evaluation of ground-glass opacity on high-resolution images. Gen Thorac Cardiovasc Surg. 2012; 60(7):425-30. PMC: 3388248. DOI: 10.1007/s11748-012-0066-7. View

Murakawa T, Konoeda C, Ito T, Inoue Y, Sano A, Nagayama K . The ground glass opacity component can be eliminated from the T-factor assessment of lung adenocarcinoma. Eur J Cardiothorac Surg. 2012; 43(5):925-32. DOI: 10.1093/ejcts/ezs467. View

Kondo T, Yamada K, Noda K, Nakayama H, Kameda Y . Radiologic-prognostic correlation in patients with small pulmonary adenocarcinomas. Lung Cancer. 2002; 36(1):49-57. DOI: 10.1016/s0169-5002(01)00448-2. View

Kakinuma R, Kodama K, Yamada K, Yokoyama A, Adachi S, Mori K . Performance evaluation of 4 measuring methods of ground-glass opacities for predicting the 5-year relapse-free survival of patients with peripheral nonsmall cell lung cancer: a multicenter study. J Comput Assist Tomogr. 2008; 32(5):792-8. DOI: 10.1097/RCT.0b013e31815688ae. View

Yang F, Chen H, Xiang J, Zhang Y, Zhou J, Hu H . Relationship between tumor size and disease stage in non-small cell lung cancer. BMC Cancer. 2010; 10:474. PMC: 2941504. DOI: 10.1186/1471-2407-10-474. View

10.

Uehara H, Tsutani Y, Okumura S, Nakayama H, Adachi S, Yoshimura M . Prognostic role of positron emission tomography and high-resolution computed tomography in clinical stage IA lung adenocarcinoma. Ann Thorac Surg. 2013; 96(6):1958-65. DOI: 10.1016/j.athoracsur.2013.06.086. View

11.

Tsutani Y, Miyata Y, Mimae T, Kushitani K, Takeshima Y, Yoshimura M . The prognostic role of pathologic invasive component size, excluding lepidic growth, in stage I lung adenocarcinoma. J Thorac Cardiovasc Surg. 2013; 146(3):580-5. DOI: 10.1016/j.jtcvs.2013.04.032. View

12.

Min J, Lee H, Lee K, Han J, Park K, Ahn M . Stepwise evolution from a focal pure pulmonary ground-glass opacity nodule into an invasive lung adenocarcinoma: an observation for more than 10 years. Lung Cancer. 2010; 69(1):123-6. DOI: 10.1016/j.lungcan.2010.04.022. View

13.

Haro A, Yano T, Kohno M, Yoshida T, Okamoto T, Maehara Y . Ground-glass opacity lesions on computed tomography during postoperative surveillance for primary non-small cell lung cancer. Lung Cancer. 2011; 76(1):56-60. DOI: 10.1016/j.lungcan.2011.09.002. View

14.

Tsutani Y, Miyata Y, Nakayama H, Okumura S, Adachi S, Yoshimura M . Prognostic significance of using solid versus whole tumor size on high-resolution computed tomography for predicting pathologic malignant grade of tumors in clinical stage IA lung adenocarcinoma: a multicenter study. J Thorac Cardiovasc Surg. 2011; 143(3):607-12. DOI: 10.1016/j.jtcvs.2011.10.037. View

15.

Maeyashiki T, Suzuki K, Hattori A, Matsunaga T, Takamochi K, Oh S . The size of consolidation on thin-section computed tomography is a better predictor of survival than the maximum tumour dimension in resectable lung cancer. Eur J Cardiothorac Surg. 2012; 43(5):915-8. DOI: 10.1093/ejcts/ezs516. View

16.

Ikeda K, Awai K, Mori T, Kawanaka K, Yamashita Y, Nomori H . Differential diagnosis of ground-glass opacity nodules: CT number analysis by three-dimensional computerized quantification. Chest. 2007; 132(3):984-90. DOI: 10.1378/chest.07-0793. View

17.

Fuji H, Asada Y, Numano M, Yamashita H, Nishimura T, Hashimoto T . Residual motion and duty time in respiratory gating radiotherapy using individualized or population-based windows. Int J Radiat Oncol Biol Phys. 2009; 75(2):564-70. DOI: 10.1016/j.ijrobp.2009.03.074. View

18.

Mehta S, Chaudhury S, Bhattacharyya A, Jena A . A soft-segmentation visualization scheme for magnetic resonance images. Magn Reson Imaging. 2005; 23(7):817-28. DOI: 10.1016/j.mri.2005.05.003. View

19.

Morgensztern D, Waqar S, Subramanian J, Gao F, Trinkaus K, Govindan R . Prognostic significance of tumor size in patients with stage III non-small-cell lung cancer: a surveillance, epidemiology, and end results (SEER) survey from 1998 to 2003. J Thorac Oncol. 2012; 7(10):1479-84. DOI: 10.1097/JTO.0b013e318267d032. View

20.

Ge X, Gao F, Li M, Chen Y, Lu F, Ren Q . [Diagnostic value of solid component for lung adenocarcinoma shown as ground-glass nodule on computed tomography]. Zhonghua Yi Xue Za Zhi. 2014; 94(13):1010-3. View