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The "solid" component within subsolid nodules: imaging definition, display, and correlation with invasiveness of lung adenocarcinoma, a comparison of CT histograms and subjective evaluation.

Abstract：

OBJECTIVE:To validate three proposed definitions of the "solid" component of subsolid nodules, as compared to CT histograms and the use of different window settings, for discriminating the invasiveness of adenocarcinomas in a manner that facilitates routine clinical assessment. METHODS:We retrospectively analyzed 328 pathologically confirmed lung adenocarcinomas, manifesting as subsolid nodules. Three-dimensional CT histograms were generated by setting 11 CT attenuation intervals from - 400 to 50 HU, at 50 HU intervals, and the voxel percentage within each CT attenuation interval was generated automatically. Three definitions of the "solid" component were proposed, and 10 medium window settings were set to evaluate the "solid" component. The diagnostic performance of the three definitions for identifying invasive adenocarcinoma was compared with that of CT histogram analysis and subjective evaluation with medium window settings. RESULTS:A parallel diagnosis using five intervals with the largest AUC (AUC ≥ 0.797) demonstrated good differential diagnostic performance, with 78% sensitivity and 73.7% specificity. Definition 2 (visibility in the mediastinum window) yielded higher accuracy (75.6%) than the other two definitions (p < 0.01). A medium window setting of - 50 WL/2 WW gave a larger AUC than the other nine medium window settings as well as definition 2, with 82.5% specificity and 88.5% PPV, which was higher than those of parallel diagnosis with CT histogram and definition 2. CONCLUSION:Using - 50 WL/2 WW is the optimum approach for evaluating the "solid" component and discriminating invasiveness, superior to using 3D CT histograms and definition 2, and convenient in routine clinical assessment. KEY POINTS:• - 50 WL/2 WW gave a larger AUC than definition 2. • The specificity of - 50 WL/2 WW was higher than CT histograms. • - 50 WL/2 WW offers the best evaluation of the solid component.

journal_name

Eur Radiol

journal_title

European radiology

authors

Tu W,Li Z,Wang Y,Li Q,Xia Y,Guan Y,Xiao Y,Fan L,Liu S

doi

10.1007/s00330-018-5778-3

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

1703-1713

issue

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-018-5778-3

journal_volume

pub_type

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The "solid" component within subsolid nodules: imaging definition, display, and correlation with invasiveness of lung adenocarcinoma, a comparison of CT histograms and subjective evaluation.