Solitary ground-glass opacity nodules of stage IA pulmonary adenocarcinoma: combination of 18F-FDG PET/CT and high-resolution computed tomography features to predict invasive adenocarcinoma
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Jun Zhou1,2,3, Yanli Li1,2,3, Yiqiu Zhang1,2,3, Guobing Liu1,2,3, Hui Tan1,2,3, Yan Hu1,2,3, Jie Xiao1,2,3, Hongcheng Shi1,2,3
1Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China
2Nuclear Medicine Institute of Fudan University, Shanghai 200032, China
3Shanghai Institute of Medical Imaging, Shanghai 200032, China
Hongcheng Shi, email: firstname.lastname@example.org
Keywords: positron emission tomography/computed tomography, high-resolution computed tomography, lung cancer, invasive adenocarcinoma, ground-glass opacity nodule
Received: September 08, 2016 Accepted: February 13, 2017 Published: February 21, 2017
To investigate the performance of combined 18F-FDG Positron Emission Tomography/Computed Tomography with high-resolution CT for differentiating invasive adenocarcinoma from adenocarcinoma in situ (pre-invasive lesion) or minimally invasive adenocarcinoma in stage IA lung cancer patients with solitary ground-glass opacity nodules. This retrospective study enrolled 58 consecutive stage IA pulmonary adenocarcinoma patients with solitary ground-glass opacity nodules. The characteristics and measurements of the ground-glass opacity nodules as pure ground-glass opacity nodules and mixed ground-glass opacity nodules in the pre-invasive or minimally invasive adenocarcinoma and invasive adenocarcinoma groups on Positron Emission Tomography/Computed Tomography and high-resolution CT were compared and analyzed. Ground-glass opacity nodules in the pre-invasive or minimally invasive adenocarcinoma group preferentially manifested as pure ground-glass opacity nodule (p < 0.01) compared to the invasive adenocarcinoma group. While cystic appearance was more common in the invasive adenocarcinoma group (p < 0.05). Significant differences were found in the diameter of the ground-glass opacity nodule itself and its solid component, and consolidation/tumor ratio between the two groups. The sensitivity in predicting invasive adenocarcinoma was higher with a combined consolidation/tumor ratio > 0.38 and SUVmax > 1.46 in mixed ground-glass opacity nodule when compared to those of SUVmax > 0.95 alone or consolidation/tumor ratio > 0.39 alone (both p < 0.05). For a mixed ground-glass opacity nodule combined consolidation/tumor ratio > 0.38 and SUVmax > 1.46 appears to better predict invasive adenocarcinoma in stage IA lung cancer patients with solitary ground-glass opacity nodules.
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