Discriminating invasive adenocarcinoma among lung pure ground-glass nodules: a multi-parameter prediction model

Hu, Fuying; Huang, Haihua; Jiang, Yunyan; Feng, Minxiang; Wang, Hao; Tang, Min; Zhou, Yi; Tan, Xianhua; Xu, Chunli; Ding, Ning; Bai, Chunxue; Hu, Jie; Yang, Dawei; Zhang, Yong

doi:10.21037/jtd-21-786

Cited by 20 publications

(20 citation statements)

References 31 publications

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Section: Discussionsupporting

confidence: 88%

“…Previous studies have qualitatively reported that enlarged intranodular vessels were a crucial indicator in helping clinicians to assess the invasiveness of GGNs before surgery. 19,22 The quantitative analysis of our study supports these results. Our data showed statistically significant differences in intranodular vessel volume and volume percentage among PGL, MIA, and IAC with DL-assisted vessel segmentation and 3D reconstruction.…”

Section: Accurate Diagnosis Among Pgl Mia and Iac Using Quantitative ...supporting

confidence: 85%

“…[15][16][17] Recently, several studies found some qualitative features of intranodular vessels including internal stiff, distorted, and enlarged vasculature were closely related to pathologic invasiveness of lung adenocarcinoma manifesting as GGNs. 18,19 However, few studies quantitatively evaluated the relationship between intranodular vessels and PGL, MIA, and IAC (manifested as GGNs). This study investigated whether quantitative features of intranodular vessels could help to distinguish between PGL, MIA, and IAC.…”

mentioning

confidence: 99%

“…Some studies identified the role of the pulmonary artery and vein in the blood supply of early lung adenocarcinomas and their abnormal morphology might be related to tumor size and invasiveness 15–17 . Recently, several studies found some qualitative features of intranodular vessels including internal stiff, distorted, and enlarged vasculature were closely related to pathologic invasiveness of lung adenocarcinoma manifesting as GGNs 18,19 . However, few studies quantitatively evaluated the relationship between intranodular vessels and PGL, MIA, and IAC (manifested as GGNs).…”

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confidence: 99%

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Correlation Between Intranodular Vessels and Tumor Invasiveness of Lung Adenocarcinoma Presenting as Ground-glass Nodules

Zhao,

Wang,

Sun

et al. 2023

Journal of Thoracic Imaging

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Purpose: To evaluate the role of quantitative features of intranodular vessels based on deep learning in distinguishing pulmonary adenocarcinoma invasiveness. Materials and Methods: This retrospective study included 512 confirmed ground-glass nodules from 474 patients with 241 precursor glandular lesions (PGL), 126 minimally invasive adenocarcinomas (MIA), and 145 invasive adenocarcinomas (IAC). The pulmonary blood vessels were reconstructed on noncontrast computed tomography images using deep learning-based region-segmentation and region-growing techniques. The presence of intranodular vessels was evaluated based on the automatic calculation of vessel prevalence, vascular categories, and vessel volume percentage. Further comparisons were made between different invasive groups by the Mantel-Haenszel χ2 test, χ2 test, and analysis of variance. Results: The detection rate of intranodular vessels in PGL (33.2%) was significantly lower than that of MIA (46.8%, P = 0.011) and IAC (55.2%, P < 0.001), while the vascular categories were similar (all P > 0.05). Vascular changes were more common in IAC and MIA than in PGL, mainly in increased vessel volume percentage (12.4 ± 19.0% vs. 6.3 ± 13.1% vs. 3.9 ± 9.4%, P < 0.001). The average intranodular artery and vein volume percentage of IAC (7.5 ± 14.0% and 5.0 ± 10.1%) was higher than that of PGL (2.1 ± 6.9% and 1.7 ± 5.8%) and MIA (3.2 ± 9.1% and 3.1 ± 8.7%), with statistical significance (all P < 0.05). Conclusions: The quantitative analysis of intranodular vessels on noncontrast computed tomography images demonstrated that the ground-glass nodules with increased internal vessel prevalence and volume percentages had higher possibility of tumor invasiveness.

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Section: Discussionsupporting

confidence: 88%

Section: Accurate Diagnosis Among Pgl Mia and Iac Using Quantitative ...supporting

confidence: 85%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Correlation Between Intranodular Vessels and Tumor Invasiveness of Lung Adenocarcinoma Presenting as Ground-glass Nodules

Zhao,

Wang,

Sun

et al. 2023

Journal of Thoracic Imaging

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“…The results suggested that enhanced CT is more valuable in the diagnosis of vascular tumor thrombus and nerve invasion of lung adenocarcinoma than plain CT, which can guide the clinical development of effective diagnosis and treatment plan. The application of spiral CT effectively improves the diagnostic accuracy, and the reconstructed CT image can observe the lesion characteristics from multiple angles and objectively analyze the lesion characteristics to improve the diagnostic accuracy and guide the clinical rational treatment of diseases ( 7 , 19 ).…”

Section: Discussionmentioning

confidence: 99%

Study on the Correlation Between CT Features and Vascular Tumor Thrombus Together With Nerve Invasion in Surgically Resected Lung Adenocarcinoma

Yu¹,

Chen²,

Lian³

et al. 2022

Front. Surg.

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BackgroundWe aimed to analyze the relationship between pulmonary adenocarcinoma patients with vascular tumor thrombus and nerve invasion and different CT features.MethodsThe preoperative CT scanning data of 86 patients with lung adenocarcinoma who underwent surgical resection in our hospital from January 2020 to January 2022 were analyzed in the form of retrospective analysis. The CT images of all patients were observed, and the relationship between them and vascular tumor thrombus and nerve invasion of lung adenocarcinoma was analyzed. At the same time, the sensitivity, specificity, and accuracy of enhanced CT and plain CT were compared to evaluate the diagnostic efficacy of both.ResultsThe results showed that the vascular tumor thrombus of lung adenocarcinoma was mainly related to the solid components and lobulated and calcified tumors in CT images, and the nerve invasion of lung adenocarcinoma was mainly related to the tumors with bronchial inflation sign in CT images (P < 0.05). The sensitivity, specificity, and accuracy of enhanced CT in the diagnosis of vascular tumor thrombus were 78.26%, 96.83%, and 91.86%, respectively, and the sensitivity, specificity, and accuracy in the diagnosis of nerve invasion were 75.00%, 98.72%, and 96.51%, respectively. The sensitivity, specificity, and accuracy of plain CT in the diagnosis of vascular tumor thrombus were 43.48%, 92.06%, and 79.07%, respectively, and the sensitivity, specificity, and accuracy in the diagnosis of nerve invasion were 25.00%, 94.87%, and 88.37%, respectively. The contrast showed that the sensitivity and accuracy of enhanced CT were higher than those of plain CT (P < 0.05), but the difference of specificity was not obvious (P > 0.05).ConclusionsSolid components and lobulated and calcified tumors in CT signs are closely related to vascular tumor thrombus of lung adenocarcinoma, while patients with bronchial inflation sign are related to nerve invasion.

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CT‐based radiomics model to predict spread through air space in resectable lung cancer

Gong,

Yin,

Sun

et al. 2023

Cancer Medicine

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BackgroundSpread through air space (STAS) has been identified as a pathological pattern associated with lung cancer progression. Patients with STAS were related to a worse prognosis compared with patients without STAS. The objective of this study was to establish a radiomics model capable of forecasting STAS before surgery, which can assist surgeons in selecting the most appropriate operation type for patients with STAS.MethodThere were 537 eligible patients retrospectively included in this study. ROI segmentation was performed manually on all CT images to identify the region of interest. From each segmented lesion, a total of 1688 features were extracted. The tumor size, maximum tumor diameters, and tumor type were also recorded. Using Spearman's correlation coefficient to calculate the correlation and redundancy of elements, and redundant features less than 0.80 were removed. In order to reduce the level of overfitting and avoid statistical biases, a dimension reduction process of the dataset was conducted to decrease the number of features. Finally, a radiomics model included 44 features was established to predict STAS. To evaluate the performance of the model, the receiver operating characteristic (ROC) curve was used, and the area under the curve (AUC) was calculated, and the accuracy of the model was verified by 10‐fold cross‐validation.ResultsThe incidence of STAS was 38.2% (205/537). The tumor type, maximum tumor diameters, and consolidation tumor ratio were significantly different between STAS group and non‐STAS group. The training group included 430 patients, while the test group was consisted with 107. The training group achieved an AUC of 0.825 (sensitivity, 0.875; specificity, 0.621; and accuracy, 0.749) and the test group had an AUC of 0.802 (sensitivity, 0.797; specificity,0.688; and accuracy, 0.748). The 10‐fold cross‐validation had an AUC of 0.834.ConclusionCT‐based radiomic model can predict STAS effectively, which is of great importance to guide the selection of operation types before surgery.

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Discriminating invasive adenocarcinoma among lung pure ground-glass nodules: a multi-parameter prediction model

Cited by 20 publications

References 31 publications

Correlation Between Intranodular Vessels and Tumor Invasiveness of Lung Adenocarcinoma Presenting as Ground-glass Nodules

Correlation Between Intranodular Vessels and Tumor Invasiveness of Lung Adenocarcinoma Presenting as Ground-glass Nodules

Study on the Correlation Between CT Features and Vascular Tumor Thrombus Together With Nerve Invasion in Surgically Resected Lung Adenocarcinoma

CT‐based radiomics model to predict spread through air space in resectable lung cancer

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