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European Radiology

Erschienen in:

25.06.2018 | Chest

CT diagnosis of pleural and stromal invasion in malignant subpleural pure ground-glass nodules: an exploratory study

verfasst von: Qing Zhao, Jian-wei Wang, Lin Yang, Li-yan Xue, Wen-wen Lu

Erschienen in: European Radiology | Ausgabe 1/2019

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Abstract

Objectives

To assess the risk of visceral pleural invasion (VPI) and improve the diagnosis of invasive adenocarcinoma (IA) in pure ground-glass nodules (pGGNs) in contact with pleura, through a comprehensive analysis of the thin-section CT features of subpleural malignant pGGNs.

Methods

CT findings and clinical information of 115 consecutive patients in our hospital between January 2012 and December 2015 who met the following criteria were retrospectively studied: (a) thin-section CT within 1 month before surgery proved pGGN in contact with pleura, and (b) the pGGN was confirmed as malignancy by surgery. Univariate analysis and a multivariate logistic regression analysis were conducted to identify the independent risk factors of IA and VPI.

Results

No pleural invasion was observed microscopically in any of the pGGNs. Univariate analysis indicated that tumour shape (p = 0.004), relative density (p = 0.038) and the existence of pleural retraction (p < 0.001) were significantly different between the invasive group and pre- or minimally invasive group. Multivariate logistic regression analysis revealed that pleural retraction (OR, 5.663; p < 0.001), lobulated tumour shape (OR, 4.812; p = 0.016) and tumour relative density greater than 1.60 (OR, 4.449; p = 0.001) were independent risk factors of IA.

Conclusions

Pulmonary adenocarcinoma manifesting as pGGN generally does not invade the pleura. A comprehensive consideration of tumour shape, relative density and tumour–pleural relationship can independently predict IA.

Key Points

• This study showed that pGGN-like adenocarcinoma generally does not invade the pleura.

• This study suggested that persistent pGGN with pleural retraction, lobulated shape and high relative density (> 1.60) may very likely be invasive adenocarcinoma.

• Using “relative density” can reduce confounding of contrast agent and respiratory status in analysis of CT images.

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Titel: CT diagnosis of pleural and stromal invasion in malignant subpleural pure ground-glass nodules: an exploratory study
verfasst von: Qing Zhao
Jian-wei Wang
Lin Yang
Li-yan Xue
Wen-wen Lu
Publikationsdatum: 25.06.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 1/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5558-0

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Springer Medizin

CT diagnosis of pleural and stromal invasion in malignant subpleural pure ground-glass nodules: an exploratory study

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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Update Radiologie

Springer Medizin

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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