Analysis of the relevance between computed tomography characterization and pathology of pulmonary ground-glass nodules with different pathology types

Zhang Youguo; Wang Chengye; Cheng Xiaofei; Zhang Xuefei; Liu Changhong

doi:10.5606/tgkdc.dergisi.2023.22239

Analysis of the relevance between computed tomography characterization and pathology of pulmonary ground-glass nodules with different pathology types

Turk Gogus Kalp Damar Cerrahisi Derg. 2023 Jan 30;31(1):95-104. doi: 10.5606/tgkdc.dergisi.2023.22239. eCollection 2023 Jan.

Authors

Zhang Youguo¹, Wang Chengye¹, Cheng Xiaofei¹, Zhang Xuefei¹, Liu Changhong¹

Affiliation

¹ Department of Thoracic Surgery 1, The Second Hospital of Dalian Medical University, Dalian, China.

Abstract

Background: In this study, we aimed to analyze the relevance between computed tomography characterization and pathology of pulmonary ground-glass nodules with different pathology types.

Methods: Between January 2017 and December 2018, a total of 657 patients (191 males, 466 females; mean age: 60.9±8.1 years; range, 34 to 80 years) with pathologically diagnosed ground-glass nodules were retrospectively analyzed. The clinicopathological characteristics and computed tomography characterizations of patients with ground-glass nodules who received surgical resection were analyzed. The clinical data including age, sex, smoking status and medical history were recorded. Computed tomography characterizations included the location and size of the tumor, the size of the consolidation components, density uniformity, shape, margin, tumor-lung interface, internal signs and surrounding signs.

Results: Based on the computed tomography imaging characteristics, a mean computed tomography value of ≥444.5 HU was more likely to indicate malignant lesions, while ≤444.5 HU indicated benign lesions. A malignant ground-glass nodules" maximum diameter of <6.78 mm, a diameter of the consolidation component of <3.88 mm, and a mean computed tomography value of <-536.5 HU were more likely to indicate atypical adenomatous hyperplasia and adenocarcinoma in situ. A maximum diameter of malignant ground-glass nodules of >11.52 mm, a diameter of the consolidation component of >6.20 mm, and a mean computed tomography value of ≥493.5 HU were more likely to indicate invasive adenocarcinomas. The focus between these parameters indicated minimally invasive adenocarcinomas.

Conclusion: Ill-defined tumor-lung interface, irregular in shape, and smooth nodule margins suggest benign lesions while round or oval, clear tumor-lung interface, spiculation signs, lobulation signs, bubble signs, air bronchograms, pleural indentations, and vessel convergences are helpful in the diagnosis of malignant lesions. A clear tumor-lung interface, the spiculation signs, lobulation signs, and bubble signs indicate the invasion of the lesions.

Keywords: Computed tomography; ground-glass nodules; lung neoplasms; pathology.