Quantitative CT Analysis for Predicting the Behavior of Part-Solid Nodules with Solid Components Less than 6 mm: Size, Density and Shape Descriptors

Andrea Borghesi,Giulio Calandra,Roberto Maroldi,Andrea Tironi,Silvia Michelini,Salvatore Golemi,Alessandra Scrimieri

doi:10.3390/app9163428

Andrea Borghesi, Giulio Calandra + Show 5 more

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https://doi.org/10.3390/app9163428

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Abstract

Persistent part-solid nodules (PSNs) with a solid component <6 mm usually represent minimally invasive adenocarcinomas and are significantly less aggressive than PSNs with a solid component ≥6 mm. However, not all PSNs with a small solid component behave in the same way: some nodules exhibit an indolent course, whereas others exhibit more aggressive behavior. Thus, predicting the future behavior of this subtype of PSN remains a complex and fascinating diagnostic challenge. The main purpose of this study was to apply open-source software to investigate which quantitative computed tomography (CT) features may be useful for predicting the behavior of a select group of PSNs. We retrospectively selected 50 patients with a single PSN with a solid component <6 mm and diameter <15 mm. Computerized analysis was performed using ImageJ software for each PSN and various quantitative features were calculated from the baseline CT images. The area, perimeter, mean Feret diameter, linear mass density, circularity and solidity were significantly related to nodule growth (p ≤ 0.031). Therefore, quantitative CT analysis was helpful for predicting the future behavior of a select group of PSNs with a solid component <6 mm and diameter <15 mm.

Highlights

Lung nodules represent a common finding on chest computed tomography (CT), and their incidence is steadily increasing [1,2,3]
The study sample was selected according to the following inclusion criteria: (a) solitary part-solid nodules (PSNs) with a solid component
The linear mass density (LMD)-DT calculated by matching the baseline and last follow-up CT images ranged from 343 to 25520 days

Summary

Introduction

Lung nodules represent a common finding on chest computed tomography (CT), and their incidence is steadily increasing [1,2,3]. With improvements in temporal and spatial resolution, multidetector CT (MDCT) scanners are able to detect a larger number of nodules, especially small nodules and subsolid nodules (SSNs) [1,3,4,5]. SSNs, called ground-glass nodules, are classified as nonsolid or part-solid nodules (PSNs) according to the absence or presence of a solid component within the ground-glass opacity [6,7]. SSNs are a major diagnostic challenge because they may represent a wide variety of malignant and benign lesions [8]. When an SSN persists, the size and density remain unchanged, the likelihood of malignancy is very high, in PSNs [9,10]. Persistent PSNs have a high likelihood of being minimally invasive or invasive adenocarcinomas [7,8,9]

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