Quantitative CT analysis of pulmonary ground-glass opacity nodules for distinguishing invasive adenocarcinoma from non-invasive or minimally invasive adenocarcinoma: the added value of using iodine mapping
- Authors
- Son J.Y.[Son J.Y.]; Lee H.Y.[Lee H.Y.]; Kim J.-H.[Kim J.-H.]; Han J.[Han J.]; Jeong J.Y.[Jeong J.Y.]; Lee K.S.[Lee K.S.]; Kwon O.J.[Kwon O.J.]; Shim Y.M.[Shim Y.M.]
- Issue Date
- 2016
- Publisher
- Springer Verlag
- Keywords
- Pure ground glass opacity; Lung adenocarcinoma; Dual-energy CT; Iodine quantification; Histogram analysis
- Citation
- European Radiology, v.26, no.1, pp.43 - 54
- Indexed
- SCIE
SCOPUS
- Journal Title
- European Radiology
- Volume
- 26
- Number
- 1
- Start Page
- 43
- End Page
- 54
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/41852
- DOI
- 10.1007/s00330-015-3816-y
- ISSN
- 0938-7994
- Abstract
- Objectives: To determine whether quantitative analysis of iodine-enhanced images generated from dual-energy CT (DECT) have added value in distinguishing invasive adenocarcinoma from non-invasive or minimally invasive adenocarcinoma (MIA) showing ground-glass nodule (GGN). Methods: Thirty-four patients with 39 GGNs were enrolled in this prospective study and underwent DECT followed by complete tumour resection. Various quantitative imaging parameters were assessed, including virtual non-contrast (VNC) imaging and iodine-enhanced imaging. Results: Of all 39 GGNs, four were adenocarcinoma in situ (AIS) (10 %), nine were MIA (23 %), and 26 were invasive adenocarcinoma (67 %). When assessing only VNC imaging, multivariate analysis revealed that mass, uniformity, and size-zone variability were independent predictors of invasive adenocarcinoma (odds ratio [OR] = 19.92, P = 0.02; OR = 0.70, P = 0.01; OR = 16.16, P = 0.04, respectively). After assessing iodine-enhanced imaging with VNC imaging, both mass on the VNC imaging and uniformity on the iodine-enhanced imaging were independent predictors of invasive adenocarcinoma (OR = 5.51, P = 0.04 and OR = 0.67, P < 0.01). The power of diagnosing invasive adenocarcinoma was improved after adding the iodine-enhanced imaging parameters versus VNC imaging alone, from 0.888 to 0.959, respectively (P = 0.029). Conclusion: Quantitative analysis using iodine-enhanced imaging metrics versus VNC imaging metrics alone generated from DECT have added value in distinguishing invasive adenocarcinoma from AIS or MIA. Key Points: • Quantitative analysis using DECT was used to distinguish invasive adenocarcinoma. • Tumour mass and uniformity were independent predictors of invasive adenocarcinoma. • Diagnostic performance was improved after adding iodine parameters to VNC parameters. © 2015, European Society of Radiology.
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