Clinical and Radiological Discrimination of Solitary Pulmonary Lesions in Colorectal Cancer Patients

Ohtaki, Yoichi; Shimizu, Kimihiro; Nagashima, Toshiteru; Nakazawa, Shozo; Obayashi, Kai; Azuma, Yoko; Iijima, Misaki; Kosaka, Takayuki; Yajima, Toshiki; Ogawa, Hiroomi; Tsutsumi, Soichi; Arai, Motohiro; Mogi, Akira; Kuwano, Hiroyuki

doi:10.1007/s00268-017-4243-9

Cited by 9 publications

(10 citation statements)

References 30 publications

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“…The value of clinical and imaging characteristics in differential diagnosis between SPLCs and PMs has been reported in our previous study (10) and other articles (11)(12)(13)(14). However, there is a lack of radiomics studies concerning the distinctions.…”

Section: Introductionmentioning

confidence: 74%

“…Despite some observer bias, the subjective radiographic characteristic is the most frequently used method for describing pulmonary lesions. Pulmonary GGO lesions have shown that tumor cells grow along the alveolar wall and are known to be a key sign of primary lung adenocarcinoma ( 11 , 14 , 32 ). This was also observed at the present research institution ( 10 ); therefore, only solid lesions were employed in this study.…”

Section: Discussionmentioning

confidence: 99%

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Radiomics Study for Discriminating Second Primary Lung Cancers From Pulmonary Metastases in Pulmonary Solid Lesions

Zhong

Liu

et al. 2022

Front. Oncol.

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BackgroundThe objective of this study was to assess the value of quantitative radiomics features in discriminating second primary lung cancers (SPLCs) from pulmonary metastases (PMs).MethodsThis retrospective study enrolled 252 malignant pulmonary nodules with histopathologically confirmed SPLCs or PMs and randomly assigned them to a training or validation cohort. Clinical data were collected from the electronic medical records system. The imaging and radiomics features of each nodule were extracted from CT images.ResultsA rad-score was generated from the training cohort using the least absolute shrinkage and selection operator regression. A clinical and radiographic model was constructed using the clinical and imaging features selected by univariate and multivariate regression. A nomogram composed of clinical-radiographic factors and a rad-score were developed to validate the discriminative ability. The rad-scores differed significantly between the SPLC and PM groups. Sixteen radiomics features and four clinical-radiographic features were selected to build the final model to differentiate between SPLCs and PMs. The comprehensive clinical radiographic–radiomics model demonstrated good discriminative capacity with an area under the curve of the receiver operating characteristic curve of 0.9421 and 0.9041 in the respective training and validation cohorts. The decision curve analysis demonstrated that the comprehensive model showed a higher clinical value than the model without the rad-score.ConclusionThe proposed model based on clinical data, imaging features, and radiomics features could accurately discriminate SPLCs from PMs. The model thus has the potential to support clinicians in improving decision-making in a noninvasive manner.

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Section: Introductionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Radiomics Study for Discriminating Second Primary Lung Cancers From Pulmonary Metastases in Pulmonary Solid Lesions

Zhong

Liu

et al. 2022

Front. Oncol.

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“…However, the margin of a nodule is more irregular when the size of isolated lung metastasis is increased [ 23 ]. Ohtaki et al have reported that the presence or absence of GGO and pleural indentation can be helpful factors to distinguish between PLC and lung metastasis from CRC [ 24 ]. In their study, patients with more than one SPN are also included.…”

Section: Discussionmentioning

confidence: 99%

“…Early detection and immediate surgical resection may prolong survival and improve prognosis [ 25 ]. However, Ohtaki et al have found that the outcome of CRC patients with lung metastasis is significantly better than the patients with radiologically solid lung cancer [ 24 ]. In their opinion, the introduction of less invasive surgical techniques, perioperative management, and various types of chemotherapy has improved the survival of CRC patients with lung metastasis.…”

Section: Discussionmentioning

confidence: 99%

Imaging Characteristics and Prognostic Value of Isolated Pulmonary Metastasis from Colorectal Cancer Demonstrated with18F-FDG PET/CT

Zhu

Zhou

et al. 2022

BioMed Research International

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Objective. Solitary pulmonary lesions (SPNs) in patients with a history of colorectal cancer (CRC) may be attributed to metastatic lung tumors, primary lung cancer, or benign nodules. We aimed to analyze the imaging characteristics of SPNs in CRC patients to differentiate these pulmonary nodules and evaluate the prognostic value of isolated pulmonary metastasis from CRC using 18F-FDG PET/CT. Methods. From January 2013 to January 2021, 62 CRC patients with SPNs demonstrated with 18F-FDG PET/CT were retrospectively enrolled in the present study. We compared the radiological and clinical characteristics of these patients. In addition, survival time and prognostic factors were statistically analyzed using the Kaplan-Meier method and multivariable Cox proportional hazards models. Results. There were 33 cases of isolated lung metastasis, 20 cases of second primary lung cancer (SPLC), and nine cases of benign nodules. The proportion of nodules with a maximal diameter greater than the median value was lower in the isolated lung metastasis group compared with the SPLC group ( p < 0.05 ), showing polygonal shape, ill-defined margin, pleural indentation, air bronchogram, speculation, and ground-glass opacity. Patients with isolated lung metastasis had a significantly higher maximal diameter of lung lesion, SUVmax of lung lesion, and 18F-FDG uptake compared with the benign nodule group ( p < 0.05 ). Multivariate analysis revealed that the following two factors were significant independent predictors of PLC: air bronchogram (hazard ratio [HR] =22.327; 95% confidence interval [CI]: 1.910-261.061; p = 0.013 ) and spiculation (HR =6.148; 95% CI 1.469-25.725; p = 0.013 ). Initial TNM stage IV (HR =19.831, 95% CI 1.061-370.782; p = 0.046 ) was extremely associated with a decreased lifespan of CRC patients with isolated lung metastasis. Conclusions. The result showed that CT features, including air bronchogram and spiculated margins, could be used to differentiate SPLC from single isolated lung metastasis in CRC patients. In patients with isolated lung metastasis, primary CRC TNM stage IV was associated with a poorer prognosis, and patients with such conditions might need more care.

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“…Differential diagnosis by preoperative CT is often challenging in patients with a history of breast cancer and biliary tract cancer (23,24). In CRC, whether or not nodules have a GGO component have been reported to be useful in making a differential diagnosis (18). In contrast, GGO is not a suitable criterion for discriminating primary lung cancer from pulmonary metastases from breast cancer (25), pancreatic cancer (26), malignant melanoma ( 27), or transitional cell carcinoma of urinary tract (14).…”

Section: Radiological Examinationsmentioning

confidence: 99%

Preoperative evaluation and indications for pulmonary metastasectomy

Kanzaki¹,

Fukui²,

Kanou³

et al. 2021

J Thorac Dis

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Pulmonary metastasectomy (PM) is an established treatment that can provide improved longterm survival for patients with metastatic tumor(s) in the lung. In the current era, where treatment options other than PM such as stereotactic body radiation therapy (SBRT), immunotherapy, and molecular-targeted therapy are available, thoracic surgeons should review the approach to the preoperative evaluation and the indications. Preoperative evaluation consists of history and physical examinations, physiological tests, and radiological examinations. Radiological examinations serve to identify the differential diagnosis of the pulmonary nodules, evaluate their precise number, location, and features, and search for extra thoracic metastases. The indication of PM should be considered from both physiological and oncological points of view. The general criteria for PM are as follows; (I) the patient has a good general condition, (II) the primary malignancy is controlled, (III) there is no other extrapulmonary metastases, and (IV) the pulmonary lesion(s) are thought to be completely resectable. In addition to the general eligibility criteria of PM, prognostic factors of each tumor type should be considered when deciding the indication for PM. When patients have multiple poor prognostic factors and/or a short disease-free interval (DFI), thoracic surgeons should not hesitate to observe the patient for a certain period before deciding on the indication for PM. A multidisciplinary discussion is needed in order to decide the indication for PM.

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Clinical and Radiological Discrimination of Solitary Pulmonary Lesions in Colorectal Cancer Patients

Abstract: The presence or absence of GGO, pathological CRC stage, and pleural indentation could be useful factors to distinguish between PLC and PM-CRC.

Cited by 9 publications

References 30 publications

Radiomics Study for Discriminating Second Primary Lung Cancers From Pulmonary Metastases in Pulmonary Solid Lesions

Radiomics Study for Discriminating Second Primary Lung Cancers From Pulmonary Metastases in Pulmonary Solid Lesions

Imaging Characteristics and Prognostic Value of Isolated Pulmonary Metastasis from Colorectal Cancer Demonstrated with18F-FDG PET/CT

Preoperative evaluation and indications for pulmonary metastasectomy

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