Benedikt H Heidinger1, Kevin R Anderson2, Eoin M Moriarty3, Daniel B Costa4, Sidhu P Gangadharan5, Paul A VanderLaan2, Alexander A Bankier3. 1. Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA; Department of Biomedical Imaging and Image-guided Therapy, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address: bheiding@bidmc.harvard.edu. 2. Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. 3. Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA. 4. Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. 5. Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Abstract
RATIONALE AND OBJECTIVES: This study aimed to compare long-axis diameter to average computed tomography (CT) diameter measurements of lung adenocarcinomas manifesting as solid lung nodules ≤30 mm on CT, as referenced to pathologic measurements, and to determine the impact of the two CT measurement approaches on tumor (T)-staging of nodules. MATERIALS AND METHODS: This institutional review board-approved study included all 274 radiologic solid adenocarcinomas resected at our institution over 10 years. Two observers measured long- and short-axis diameters on pre-resection chest CT in lung and mediastinal windows. T-stages were determined. CT measurements and T-stages were compared to pathology measurements and T-stages using Wilcoxon signed rank test and McNemar test. Inter- and intraobserver variability was determined with intraclass correlation coefficients (ICC) and Bland-Altman plots. RESULTS: For lung and mediastinal windows, nodule size was significantly larger using long-axis diameter rather than average diameter (16.93 vs. 14.92 mm, P <.001; and 14.02 vs. 12.17 mm, P <.001, respectively). The correlation of CT with pathologic measurements was stronger with long-axis than with average diameter (ICC 0.808 vs. 0.730; and 0.731 vs. 0.621, respectively). Lung window measurements correlated stronger with pathology than mediastinal window measurements. CT T-stages differed from pathology T-stages in more than 20% of nodules (P <.001). Inter- and intraobserver variability was small with long-axis and average diameter (ICC range 0.96-0.991, and 0.970-0.993, respectively), but long-axis diameter showed wider scatter on Bland-Altman plots. CONCLUSIONS: Long-axis CT diameter is preferable for T-staging because it better reflects the pathology T-stage. Average CT diameter might be used for longitudinal nodule follow-up because it shows less measurement variability and is more conservative in size assessment.
RATIONALE AND OBJECTIVES: This study aimed to compare long-axis diameter to average computed tomography (CT) diameter measurements of lung adenocarcinomas manifesting as solid lung nodules ≤30 mm on CT, as referenced to pathologic measurements, and to determine the impact of the two CT measurement approaches on tumor (T)-staging of nodules. MATERIALS AND METHODS: This institutional review board-approved study included all 274 radiologic solid adenocarcinomas resected at our institution over 10 years. Two observers measured long- and short-axis diameters on pre-resection chest CT in lung and mediastinal windows. T-stages were determined. CT measurements and T-stages were compared to pathology measurements and T-stages using Wilcoxon signed rank test and McNemar test. Inter- and intraobserver variability was determined with intraclass correlation coefficients (ICC) and Bland-Altman plots. RESULTS: For lung and mediastinal windows, nodule size was significantly larger using long-axis diameter rather than average diameter (16.93 vs. 14.92 mm, P <.001; and 14.02 vs. 12.17 mm, P <.001, respectively). The correlation of CT with pathologic measurements was stronger with long-axis than with average diameter (ICC 0.808 vs. 0.730; and 0.731 vs. 0.621, respectively). Lung window measurements correlated stronger with pathology than mediastinal window measurements. CT T-stages differed from pathology T-stages in more than 20% of nodules (P <.001). Inter- and intraobserver variability was small with long-axis and average diameter (ICC range 0.96-0.991, and 0.970-0.993, respectively), but long-axis diameter showed wider scatter on Bland-Altman plots. CONCLUSIONS: Long-axis CT diameter is preferable for T-staging because it better reflects the pathology T-stage. Average CT diameter might be used for longitudinal nodule follow-up because it shows less measurement variability and is more conservative in size assessment.
Authors: Benedikt H Heidinger; Mario Silva; Constance de Margerie-Mellon; Paul A VanderLaan; Alexander A Bankier Journal: Transl Lung Cancer Res Date: 2019-12
Authors: Benedikt H Heidinger; Ursula Schwarz-Nemec; Kevin R Anderson; Constance de Margerie-Mellon; Antonio C Monteiro Filho; Yigu Chen; Marius E Mayerhoefer; Paul A VanderLaan; Alexander A Bankier Journal: Radiol Cardiothorac Imaging Date: 2019-08-29
Authors: Ursula Nemec; Benedikt H Heidinger; Kevin R Anderson; Michael S Westmore; Paul A VanderLaan; Alexander A Bankier Journal: Eur Radiol Date: 2017-07-14 Impact factor: 5.315
Authors: Sohee Park; Sang Min Lee; Jooae Choe; June Goo Lee; Sang Min Lee; Kyung Hyun Do; Joon Beom Seo Journal: Korean J Radiol Date: 2019-07 Impact factor: 3.500
Authors: Constance de Margerie-Mellon; Ritu R Gill; Pascal Salazar; Anastasia Oikonomou; Elsie T Nguyen; Benedikt H Heidinger; Mayra A Medina; Paul A VanderLaan; Alexander A Bankier Journal: Sci Rep Date: 2020-09-03 Impact factor: 4.379