One-dimensional quantitative evaluation of peripheral lung adenocarcinoma with or without ground-glass opacity on thin-section CT images using profile curves

• Published in: British journal of radiology Vol. 82; no. 979; pp. 532 - 540
• Main Authors: YANAGAWA, M, KURIYAMA, K, NAKAMURA, H, KUNITOMI, Y, TOMIYAMA, N, HONDA, O, SUMIKAWA, H, INOUE, A, MIHARA, N, YOSHIDA, S, JOHKOH, T
• Format: Journal Article
• Language: English
• Published: London British Institute of Radiology 01.07.2009
• Subjects: Adenocarcinoma - diagnostic imaging; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Lung Neoplasms - diagnostic imaging; Lymphatic Metastasis; Male; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - diagnostic imaging; Observer Variation; Pneumology; Prognosis; Regression Analysis; Retrospective Studies; Software; Tomography, X-Ray Computed - methods; Tumors of the respiratory system and mediastinum; Lung disease; Nuclear medicine; Radiodiagnosis; Respiratory disease; Radiology; Medical imagery; Bronchus disease; Computerized axial tomography; Malignant tumor; Bronchopulmonary adenocarcinoma; Cancer; Quantitative analysis
• ISSN: 0007-1285; 1748-880X
• DOI: 10.1259/bjr/70480730

The purpose of our investigation was to compare the usefulness of the subjective visual assessment of ground-glass opacity (GGO) with a quantitative method that used a profile curve to determine prognosis. 96 adenocarcinomas were studied. Three diameters ([D1]-[D3]) were defined for estimating the diameter of tumours on the monitor: the distance between two points was measured using software that displays a CT density profile across the tumour. One experienced and one less experienced radiologist independently evaluated the following six parameters: the three diameters [D1]-[D3]; the solid portion of total tumour in the two different ratios ([D2]/[D1], [D3]/[D1]); and the area ratio of GGO for total opacity to subjective visual evaluation. Interobserver agreement between the two radiologists of the diameters (mean bias+/- 1.96 standard deviations) was as follows: [D1], -0.7 +/- 6 mm; [D2], 0.4 +/- 4.4 mm; and [D3], -0.1 +/- 4.2 mm (Bland and Altman's method). Interobserver agreement was fair in evaluating the area ratio of GGO (kappa test, kappa = 0.309). Univariate logistic regression analysis revealed that two ratios ([D2]/[D1], [D3]/[D1]) might be significantly useful in estimating lymph node metastasis (p < 0.026), lymph duct invasion (p < 0.001) and recurrence (p < 0.015). Observation of the area ratio of GGO by an experienced radiologist would be necessary for estimating lymph node metastasis (p = 0.04) and lymph duct invasion (p < 0.001). We concluded that the ratio of solid component to total tumour, which is obtainable in a more objective and simple way using profile curves obtained by software, is a more useful method of estimating prognosis than is visual assessment.