Software performance in segmenting ground-glass and solid components of subsolid nodules in pulmonary adenocarcinomas.

Abstract

To evaluate the performance of software in segmenting ground-glass and solid components of subsolid nodules in pulmonary adenocarcinomas. Seventy-three pulmonary adenocarcinomas manifesting as subsolid nodules were included. Two radiologists measured the maximal axial diameter of the ground-glass components on lung windows and that of the solid components on lung and mediastinal windows. Nodules were segmented using software by applying five (-850HU to -650HU) and nine (-130HU to -500HU) attenuation thresholds. We compared the manual and software measurements of ground-glass and solid components with pathology measurements of tumour and invasive components. Segmentation of ground-glass components at a threshold of -750HU yielded mean differences of +0.06mm (p = 0.83, 95% limits of agreement, 4.51 to 4.67) and -2.32mm (p < 0.001, -8.27 to 3.63) when compared with pathology and manual measurements, respectively. For solid components, mean differences between the software (at -350HU) and pathology measurements and between the manual (lung and mediastinal windows) and pathology measurements were -0.12mm (p = 0.74, -5.73 to 5.55]), 0.15mm (p = 0.73, -6.92 to 7.22), and -1.14mm (p < 0.001, -7.93 to 5.64), respectively. Software segmentation of ground-glass and solid components in subsolid nodules showed no significant difference with pathology. • Software can effectively segment ground-glass and solid components in subsolid nodules. • Software measurements show no significant difference with pathology measurements. • Manual measurements are more accurate on lung windows than on mediastinal windows.