Hideyuki Hayashi1, Kazuto Ashizawa2, Yukihiro Ogihara3, Akifumi Nishida4, Keitaro Matsumoto5, Naoya Yamasaki5, Takeshi Nagayasu5, Minoru Fukuda1, Sumihisa Honda6, Masataka Uetani4. 1. Unit of Translational Medicine, Department of Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. 2. Unit of Translational Medicine, Department of Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. ashi@nagasaki.u.ac.jp. 3. Department of Radiology, Nagasaki Prefectural Shimabara Hospital, Nagasaki, Japan. 4. Department of Radiological Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. 5. Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. 6. Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Abstract
OBJECTIVES: To correlate the tumor size and solid component size on thin-section CT (TS-CT) with pathological findings including lymph node (LN) metastasis and local invasion in T1 lung adenocarcinoma. METHODS: 188 patients with surgically resected T1 lung adenocarcinoma were retrospectively analyzed. Two chest radiologists measured the long-axis and short-axis dimensions of nodules and solid components with a lung and/or a mediastinal window setting (WS) on TS-CT. After analyzing interobserver agreement, average long-axis dimensions of the measured tumors and solid components were correlated with pathological findings. RESULTS: Seven of 188 patients (3.7%) had pathologic LN-positive metastasis. In patients in whom the long axis of the solid component was <5 mm with a mediastinal WS or <8 mm with a lung WS on TS-CT, no LN metastases were observed, resulting in a positive predictive value (PPV) for predicting a pathologic LN-negative status of 100% with each WS. Based on the same diagnostic criteria, the PPVs for a pathological local invasion (LI)-negative status were 91 (40/44) and 90% (55/61), respectively. CONCLUSION: Solid component size on TS-CT may have the potential to predict LN-negative or LI-negative status.
OBJECTIVES: To correlate the tumor size and solid component size on thin-section CT (TS-CT) with pathological findings including lymph node (LN) metastasis and local invasion in T1 lung adenocarcinoma. METHODS: 188 patients with surgically resected T1 lung adenocarcinoma were retrospectively analyzed. Two chest radiologists measured the long-axis and short-axis dimensions of nodules and solid components with a lung and/or a mediastinal window setting (WS) on TS-CT. After analyzing interobserver agreement, average long-axis dimensions of the measured tumors and solid components were correlated with pathological findings. RESULTS: Seven of 188 patients (3.7%) had pathologic LN-positive metastasis. In patients in whom the long axis of the solid component was <5 mm with a mediastinal WS or <8 mm with a lung WS on TS-CT, no LN metastases were observed, resulting in a positive predictive value (PPV) for predicting a pathologic LN-negative status of 100% with each WS. Based on the same diagnostic criteria, the PPVs for a pathological local invasion (LI)-negative status were 91 (40/44) and 90% (55/61), respectively. CONCLUSION: Solid component size on TS-CT may have the potential to predict LN-negative or LI-negative status.
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