Masahiro Yanagawa1, Masahiko Kusumoto2, Takeshi Johkoh3, Masayuki Noguchi4, Yuko Minami5, Fumikazu Sakai6, Hisao Asamura7, Noriyuki Tomiyama8. 1. Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: m-yanagawa@radiol.med.osaka-u.ac.jp. 2. Department of Diagnostic Radiology, National Cancer Center Hospital East, Chiba, Japan. 3. Department of Radiology, Kinki Central Hospital of Mutual Aid Association of Public School Teachers, Hyogo, Japan. 4. Department of Diagnostic Pathology, University of Tsukuba, Ibaraki, Japan. 5. Department of Pathology, National Hospital Organization Ibarakihigashi National Hospital, Center of Chest Diseases and Severe Motor and Intellectual Disabilities, Ibaraki, Japan. 6. Department of Diagnostic Radiology, Saitama International Medical Center, Saitama Medical University, Saitama, Japan. 7. Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan. 8. Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan.
Abstract
BACKGROUND: Measuring the size of invasiveness on computed tomography (CT) for the T descriptor size was deemed important in the 8th edition of the TNM lung cancer classification. We aimed to correlate the maximal dimensions of the solid portions using both lung and mediastinal window settings on CT imaging with the pathologic invasiveness (> 0.5 cm) in lung adenocarcinoma patients. MATERIALS AND METHODS: The study population consisted of 378 patients with a histologic diagnosis of adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), invasive adenocarcinoma (IVA)-lepidic, IVA-acinar and/or IVA-papillary, and IVA-micropapillary and/or solid adenocarcinoma. A panel of 15 radiologists was divided into 2 groups (group A, 9 radiologists; and group B, 6 radiologists). The 2 groups independently measured the maximal and perpendicular dimensions of the solid components and entire tumors on the lung and mediastinal window settings. The solid proportion of nodule was calculated by dividing the solid portion size (lung and mediastinal window settings) by the nodule size (lung window setting). The maximal dimensions of the invasive focus were measured on the corresponding pathologic specimens by 2 pathologists. RESULTS: The solid proportion was larger in the following descending order: IVA-micropapillary and/or solid, IVA-acinar and/or papillary, IVA-lepidic, MIA, and AIS. For both groups A and B, a solid portion > 0.8 cm in the lung window setting or > 0.6 cm in the mediastinal window setting on CT was a significant indicator of pathologic invasiveness > 0.5 cm (P < .001; receiver operating characteristic analysis using Youden's index). CONCLUSION: A solid portion > 0.8 cm on the lung window setting or solid portion > 0.6 cm on the mediastinal window setting on CT predicts for histopathologic invasiveness to differentiate IVA from MIA and AIS.
BACKGROUND: Measuring the size of invasiveness on computed tomography (CT) for the T descriptor size was deemed important in the 8th edition of the TNM lung cancer classification. We aimed to correlate the maximal dimensions of the solid portions using both lung and mediastinal window settings on CT imaging with the pathologic invasiveness (> 0.5 cm) in lung adenocarcinomapatients. MATERIALS AND METHODS: The study population consisted of 378 patients with a histologic diagnosis of adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), invasive adenocarcinoma (IVA)-lepidic, IVA-acinar and/or IVA-papillary, and IVA-micropapillary and/or solid adenocarcinoma. A panel of 15 radiologists was divided into 2 groups (group A, 9 radiologists; and group B, 6 radiologists). The 2 groups independently measured the maximal and perpendicular dimensions of the solid components and entire tumors on the lung and mediastinal window settings. The solid proportion of nodule was calculated by dividing the solid portion size (lung and mediastinal window settings) by the nodule size (lung window setting). The maximal dimensions of the invasive focus were measured on the corresponding pathologic specimens by 2 pathologists. RESULTS: The solid proportion was larger in the following descending order: IVA-micropapillary and/or solid, IVA-acinar and/or papillary, IVA-lepidic, MIA, and AIS. For both groups A and B, a solid portion > 0.8 cm in the lung window setting or > 0.6 cm in the mediastinal window setting on CT was a significant indicator of pathologic invasiveness > 0.5 cm (P < .001; receiver operating characteristic analysis using Youden's index). CONCLUSION: A solid portion > 0.8 cm on the lung window setting or solid portion > 0.6 cm on the mediastinal window setting on CT predicts for histopathologic invasiveness to differentiate IVA from MIA and AIS.
Authors: Pradnya D Patil; Samir Sultan; M Frances Hahn; Sreeja Biswas Roy; Mitchell D Ross; Hesham Abdelrazek; Ross M Bremner; Nitika Thawani; Rajat Walia; Tanmay S Panchabhai Journal: Respir Med Case Rep Date: 2018-06-12
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