The long-term course of ground-glass opacities detected on thin-section computed tomography

Lee, Sei Won; Leem, Cho Sun; Kim, Tae Jung; Lee, Kyungwon; Chung, Jin-Haeng; Jheon, Sanghoon; Lee, Jae-Ho; Lee, Choon Taek

doi:10.1016/j.rmed.2013.02.014

Cited by 88 publications

(96 citation statements)

References 45 publications

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“…The predictors of increase in tumor size or growth in consolidation of GGO dominant tumors have been previously reported to be a history of smoking, the initial tumor size (26), gender, presence of solid components and age (9). While these factors were also significant in this study based on the univariate analyses, only age was a predictor based on the multivariate analyses.…”

Section: Discussionsupporting

confidence: 46%

“…GGO dominant tumors have been increasingly observed due to widespread use of high resolution CT imaging, and many studies have reported a relationship between radiological prognostic factors and pathological invasiveness (9,14,15). The specificity of pathological invasiveness, which is defined as the presence of vascular and lymphatic invasion and lymph node metastasis, was reported to be 100% when the cut-off value was set as a consolidation/maximum tumor ratio of ≤0.5 for lesions ≤3 cm (16).…”

Section: Discussionmentioning

confidence: 99%

“…An tumor size increased was observed in 15.2-32% of tumors that were pure GGO (4-6) and 76% of tumors that were part-solid GGO (7). Solid components appeared in 2-16% of the pure GGO tumors (5,(8)(9)(10) and were increased in 9-21% of the part solid GGO tumors (5,8,9).…”

Section: Introductionmentioning

confidence: 97%

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Surgical intervention for ground glass dominant lesions: observation or outright resection?

Fukui

Suzuki

Matsunaga

et al. 2017

Japanese Journal of Clinical Oncology

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Background: The management of ground glass opacity (GGO) on computed tomography (CT) remains controversial. Information of the relationship between clinical behavior and pathological invasiveness of GGO is valuable for management. We conducted this retrospective study to establish differences in the pathological invasiveness between GGO with and without changes. Methods: Among 1762 patients, the following criteria was used: (1) maximum tumor diameter of 3 cm or less, (2) tumor having 50% or more GGO and (3) resection after at least three months of follow up. A change of CT findings was defined as an increase in the diameter or consolidation compared with the initial CT. The relationship between preoperative changes and ratio of invasive adenocarcinoma was investigated. Predictors of GGO growth were also examined. Results: There were 250 patients: pure GGO without changes (G-N group; n = 118), pure GGO with changes (G-C group; n = 35), part-solid GGO without changes (S-N group; n = 78), and partsolid GGO with changes (S-C group; n = 20). The ratio of invasive adenocarcinoma in each group was 0.54, 0.89, 0.8, and 0.90. There was a significant difference between the G-N and G-C group (P < 0.001). However, there was no significant difference between the G-C, S-N and S-C group. Multivariate analysis indicated age was a predictor of preoperative changes (OR = 1.953, P = 0.049). Conclusions:The pathological results of part-solid GGO with changes were not different from those without changes. Therefore surgery can be deferred until those lesions demonstrate changes. The pathological results of pure GGO with changes were equivalent to those of partsolid GGO. Therefore, even for pure GGO, follow up is necessary especially in elderly patients.

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Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

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Surgical intervention for ground glass dominant lesions: observation or outright resection?

Fukui

Suzuki

Matsunaga

et al. 2017

Japanese Journal of Clinical Oncology

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“…Many studies on the natural history of GGOs are based on changes of the longest diameter measured on 2D axial CT scan, and DTs have been calculated by applying the modified Schwartz formula (6,7,24,25). In two recent studies, the majority of GGOs (73.7% and 85.4%, respectively) did not grow during a long-term follow-up of more than two years (24,25).…”

Section: Discussionmentioning

confidence: 99%

“…Although the natural history and growth rate of the various lesions along the adenocarcinoma spectrum have been previously studied (6,7,(22)(23)(24)(25), to the best of our knowledge, there are no published studies in which the volume and mass changes of pulmonary adenocarcinomas with GGOs (and their respective DTs) have been investigated using 3D software for each CT performed throughout follow-up (not just the baseline and last CT scan). Therefore, this study aimed to explore the growth pattern and rate of a group of pulmonary adenocarcinomas appearing as GGOs that were retrospectively analyzed with 3D commercial software to further understand their natural volumetric behavior.…”

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confidence: 99%

Pulmonary adenocarcinomas presenting as ground-glass opacities on multidetector CT: three-dimensional computer-assisted analysis of growth pattern and doubling time

Borghesi

Farina²,

Michelini³

et al. 2016

Diagn Interv Radiol

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We aimed to evaluate the growth pattern and doubling time (DT) of pulmonary adenocarcinomas exhibiting ground-glass opacities (GGOs) on multidetector computed tomography (CT). METHODS The growth pattern and DT of 22 pulmonary adenocarcinomas exhibiting GGOs were retrospectively analyzed using three-dimensional semiautomatic software. Analysis of each lesion was based on calculations of volume and mass changes and their respective DTs throughout CT follow- up. Three-dimensional segmentation was performed by a single radiologist on each CT scan. The same observer and another radiologist independently repeated the segmentation at the baseline and the last CT scan to determine the variability of the measurements. The relationships among DTs, histopathology, and initial CT features of the lesions were also analyzed. RESULTS Pulmonary adenocarcinomas presenting as GGOs exhibited different growth patterns: some lesions grew rapidly and some grew slowly, whereas others alternated between periods of growth, stability, or shrinkage. A significant increase in volume and mass that exceeded the coefficient of repeatability of interobserver variability was observed in 72.7% and 84.2% of GGOs, respectively. The volume-DTs and mass-DTs were heterogeneous throughout the follow-up CT scan (range, -4293 to 21928 and -3113 to 17020 days, respectively), and their intra- and interobserver variabilities were moderately high. The volume-DTs and mass-DTs were not correlated with the initial CT features of GGOs; however, they were significantly shorter in invasive adenocarcinomas (P = 0.002 and P = 0.001, respectively). CONCLUSION Pulmonary adenocarcinomas exhibiting GGOs show heterogeneous growth patterns with a trend toward a progressive increase in size. DTs may be useful for predicting tumor aggressiveness

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Minimizing over‐diagnosis in lung cancer screening

Grannis

2013

Journal of Surgical Oncology

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Overestimation of the frequency and impact of over-diagnosis bias in lung cancer screening has contributed to long delays in implementation of lung cancer screening programs. Literature review reveals little evidence of substantial numbers of over-diagnosed non-lethal lung cancer. There is now strong evidence that lung cancers that would not cause symptoms or kill during normal anticipated survival are uncommon and mostly limited to in situ adenocarcinomas, identifiable as CT non-solid nodules. Prevention of overtreatment is possible within well-constructed diagnostic algorithms.

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The long-term course of ground-glass opacities detected on thin-section computed tomography

Cited by 88 publications

References 45 publications

Surgical intervention for ground glass dominant lesions: observation or outright resection?

Surgical intervention for ground glass dominant lesions: observation or outright resection?

Pulmonary adenocarcinomas presenting as ground-glass opacities on multidetector CT: three-dimensional computer-assisted analysis of growth pattern and doubling time

Minimizing over‐diagnosis in lung cancer screening

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