Arc concave sign on thin-section computed tomography：A novel predictor for invasive pulmonary adenocarcinoma in pure ground-glass nodules

Fu, Gangze; Yu, Huibo; Liu, Jinjin; Xia, Tianyi; Lü, Xiang; Huang, Dingpin; Lin, Liulan; Zhuang, Yuandi; Yang, Yunjun

doi:10.1016/j.ejrad.2021.109683

Cited by 4 publications

(2 citation statements)

References 33 publications

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“…Spiculation was defined as the presence of strands extending from the nodule’s margin into the lung parenchyma, without contacting the pleural surface. 18 Lobulation was defined as a wavy or scalloped configuration of a portion of the nodule’s surface. 19 Abnormal intra-nodular vessel was considered present when intra-nodular vascular segments were dilated (ie, diameter of vascular segment greater than that of segments proximal to the vessel’s entry into the nodule, or diameter of vascular segment significantly greater than that of other vessels at the same branch level), or distorted (ie, vessel deviated from its normal route).…”

Section: Methodsmentioning

confidence: 99%

Potential Role of Intrapulmonary Concomitant Lesions in Differentiating Non-Neoplastic and Neoplastic Ground Glass Nodules

Fu,

Zhang,

et al. 2023

JIR

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Purpose To determine the value of intrapulmonary concomitant lesions in differentiating non-neoplastic and neoplastic ground-glass nodules (GGNs). Patients and Methods From January 2014 to March 2022, 395 and 583 patients with confirmed non-neoplastic and neoplastic GGNs were retrospectively enrolled. Their clinical and chest CT data were evaluated. The CT features of target GGNs and intrapulmonary concomitant lesions in these two groups were analyzed and compared, and the role of intrapulmonary concomitant lesions in improving differentiation was evaluated. Results The intrapulmonary concomitant lesions were more common in patients with non-neoplastic GGNs than in those with neoplastic ones (87.88% vs 82.18%, P = 0.015). Specifically, patients with non-neoplastic GGNs had a higher incidence of multiple solid nodules (SNs), patchy ground-glass opacity/consolidation, and fibrosis/calcification in any lung fields (each P < 0.05). Logistic regression analysis indicated that patients < 44 years old, diameter < 7.35 mm, irregular shape, and coarse margin or ill-defined boundary for target GGN, pleural thickening, and concomitant SNs in the same lobe and fibrosis or calcification in any lung field were independent indicators for predicting non-neoplastic GGNs. The AUC of the model for predicting non-neoplastic GGNs increased from 0.894 to 0.926 (sensitivity, 83.10%; specificity, 87.10%) after including the concomitant lesions in the patients’ clinical characteristics and CT features of target GGNs (P < 0.0001). Conclusion Besides the patients’ clinical characteristics and CT features of target GGNs, the concomitant multiple SNs in the same lobe and fibrosis/calcification in any lung field should be considered in further differentiating non-neoplastic and neoplastic GGNs.

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Section: Methodsmentioning

confidence: 99%

Potential Role of Intrapulmonary Concomitant Lesions in Differentiating Non-Neoplastic and Neoplastic Ground Glass Nodules

Fu,

Zhang,

et al. 2023

JIR

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“…Air bronchogram sign was de ned as visible air-lled bronchi detected in the nodule [20]. Vacuole sign was de ned as a round or oval air density within a nodule [21], whereas spiculation sign was de ned as linear strands extending beyond the lesion [22]. Lobulation sign was de ned as a wavy or scalloped con guration of a portion of the nodule's surface [23], while pleural indentation sign was de ned as a linear strand radiating from the nodule and extending distal to the pleural surface [24].…”

Section: Image Interpretationmentioning

confidence: 99%

Artificial intelligence-based density proportion analysis in predicting the invasiveness of neoplastic ground glass nodules

Xiong,

Fu,

et al. 2024

Preprint

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Background: A positive correlation has been observed between CT value and the invasiveness of neoplastic ground glass nodules (GGNs). However, the traditional mean CT value cannot reflect nodule heterogeneity in density. Purpose: To explore the value of artificial intelligence (AI)-based density proportion analysis in predicting the invasiveness of neoplastic ground glass nodules (GGNs). Methods: Between January 2019 and May 2023, a total of 687 neoplastic GGNs (247 adenocarcinomas in situ[AISs], 231 minimally invasive adenocarcinomas [MIAs], and 209 invasive adenocarcinomas [IACs]) in 654 patients were retrospectively analyzed. AI software was used to obtain the density histograms of nodules, and subsequently the proportions of the components in lesions with higher density at different density thresholds were recorded. The optimal density threshold and the corresponding proportion cutoff value for determining invasive lesions (ILs) (MIAs and IACs) and IACs were respectively explored by conducting receiver operating characteristic curve analysis. Results: For determining the ILs and IACs, the optimal density threshold and the cutoff value for the proportion of components with density higher than the threshold were ≥ −350 HU and 17.22% (area under the curve [AUC]: 0.801, 95% confidence interval (CI): 0.769–0.830, sensitivity: 51.59%, specificity: 93.52%), and ≥ −250HU and 5.64% (AUC: 0.882, 95% CI: 0.855–0.905; sensitivity: 85.65%, specificity: 76.15%), respectively. In combination with these indicators, the AUCs of the morphological features in predicting ILs and IACs increased from 0.794 to 0.849 and from 0.843 to 0.902 (each P < 0.001), respectively. Conclusion: AI-based density analysis has a potential role in determining the invasiveness of neoplastic GGNs.

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Is 18F-fluorodeoxyglucose PET recommended for small lung nodules? CT findings of 18F-fluorodeoxyglucose non-avid lung cancer

Sugawara,

Kikkawa,

Ito

et al. 2023

British Journal of Radiology

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Objectives To determine the image characteristics associated with low 18F-FDG (18F-fluorodeoxyglucose) avidity among 8-15 mm solid lung cancer. Methods Patients satisfying the following criteria were included: underwent surgery between January 2014 and December 2019 for lung cancer, presented 8-15 mm nodule without measurable ground glass component on preoperative CT, and underwent 18F-FDG PET before resection. Image characteristics, including air bronchogram, concave shape, pleural attachment, and background emphysema, were evaluated by two board-certified radiologists. The Mann-Whitney U test was used to compare maximum standardized uptake (SUVmax) values from 18F-FDG PET images. Results The analysis included 235 patients. The SUVmax values of lesions with air bronchogram and concave shape were significantly lower than the SUVmax values of lesions without these features (median: 1.55 vs 2.56 and 1.66 vs 2.45, both P < .001), whereas lesions arising from emphysematous lungs had significantly higher SUVmax values than lesions arising from non-emphysematous lungs (2.90 vs 1.69, P < .001). No significant differences were detected between lesions attached and not attached to pleura. The interobserver agreement was almost perfect for air bronchograms and background emphysema (κ = 0.882 and 0.927, respectively), and 89.7% of lesions with air bronchograms and arising from non-emphysematous lungs showed SUVmax values below 2.5. Conclusions Among 8-15 mm solid lung cancer, the presence of air bronchograms and concave shape and the absence of background emphysema were associated with low 18F-FDG accumulation. Advances in knowledge 18F-FDG PET can be misleading in differentiating certain type of small solid lung cancer.

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Arc concave sign on thin-section computed tomography：A novel predictor for invasive pulmonary adenocarcinoma in pure ground-glass nodules

Cited by 4 publications

References 33 publications

Potential Role of Intrapulmonary Concomitant Lesions in Differentiating Non-Neoplastic and Neoplastic Ground Glass Nodules

Potential Role of Intrapulmonary Concomitant Lesions in Differentiating Non-Neoplastic and Neoplastic Ground Glass Nodules

Artificial intelligence-based density proportion analysis in predicting the invasiveness of neoplastic ground glass nodules

Is 18F-fluorodeoxyglucose PET recommended for small lung nodules? CT findings of 18F-fluorodeoxyglucose non-avid lung cancer

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