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European Radiology
Published in: European Radiology 1/2016

01-01-2016 | Chest

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: Ji Ye Son, Ho Yun Lee, Jae-Hun Kim, Joungho Han, Ji Yun Jeong, Kyung Soo Lee, O. Jung Kwon, Young Mog Shim

Published in: European Radiology | Issue 1/2016

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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.
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Metadata
Title
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
Ji Ye Son
Ho Yun Lee
Jae-Hun Kim
Joungho Han
Ji Yun Jeong
Kyung Soo Lee
O. Jung Kwon
Young Mog Shim
Publication date
01-01-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 1/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3816-y

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