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- Title
Morphological Predictors of Primary Lung Cancer among Part-Solid Ground-Grass Nodules on High-Resolution CT.
- Authors
Hirotsugu Notsuda; Hiroki Oshio; Ken Onodera; Takashi Hirama; Yui Watanabe; Tatsuaki Watanabe; Takaya Suzuki; Hisashi Oishi; Hiromichi Niikawa; Ryoko Saito-Koyama; Masafumi Noda; Junya Tominaga; Yoshinori Okada
- Abstract
Recent advancements in computed tomography (CT) scanning have improved the detection rates of peripheral pulmonary nodules, including those with ground-glass opacities (GGOs). This study focuses on part-solid pure ground-glass nodules (GGNs) and aims to identify imaging predictors that can reliably differentiate primary lung cancer from nodules with other diagnoses among part-solid GGNs on highresolution CT (HRCT). A retrospective study was conducted on 609 patients who underwent surgical treatment or observation for lung nodules. Radiological findings from pre-operative HRCT scans were reviewed and several CT imaging features of part-solid GGNs were examined for their positive predictive value to identify primary lung cancer. The proportions of the nodules with a final diagnosis of primary lung cancer were significantly higher in part-solid GGNs (91.9%) compared with solid nodules (70.3%) or pure GGNs (66.7%). Among CT imaging features of part-solid GGNs that were evaluated, consolidation-totumor ratio (CTR) < 0.5 (98.1%), pleural indentation (96.4%), and clear tumor border (96.7%) had high positive predictive value to identify primary lung cancer. When two imaging features were combined, the combination of CTR < 0.5 and a clear tumor border was identified to have 100% positive predictive values with a sensitivity of 40.8%. Thus we conclude that part-solid GGNs with a CTR < 0.5 accompanied by a clear tumor border evaluated by HRCT are very likely to be primary lung cancers with an acceptable sensitivity. Preoperative diagnostic procedures to obtain a pathological diagnosis may potentially be omitted in patients harboring such part-solid GGNs.
- Subjects
LUNG cancer; COMPUTED tomography; PULMONARY nodules
- Publication
Tohoku Journal of Experimental Medicine, 2024, Vol 263, Issue 1, p35
- ISSN
0040-8727
- Publication type
Article
- DOI
10.1620/tjem.2024.J016