Abstract
BackgroundInvasive pure ground-glass opacity and pre-invasive pure ground-glass opacity have different 5-year overall survival rate and risk of lymph node metastasis and the extent of resection. It is difficult to discriminate these nodules since they share similar CT features and may occur concurrently. The objectives of this study were to investigate the feasibility of non-contrast enhanced plus contrast-enhanced computed tomography in discriminating invasive pure ground-glass opacity from pre-invasive pure ground-glass opacity.MethodsWe retrospectively examined 90 patients with pure ground-glass opacity who underwent non-contrast enhanced and contrast-enhanced CT according to a simplified protocol (one non-contrast enhanced measurement and two contrast-enhanced measurements at 30 s and 60 s after contrast injection) from 2015 to 2019. All imaging examinations were analyzed using three-dimensional computer-aided volume. Two independent samples t tests, one-way analysis of variance, chi-square test and logistic regression were used for analysis. A receiver operating characteristic curve was used to determine the optimal cut-off value of mean CT attenuation for differentiation of groups and to obtain diagnostic value.Results(1) The CT values of one non-contrast-enhanced, two contrast-enhanced and volume measurements between two groups had statistically significant differences (P < 0.001). (2) At the 30-s scan, there were more nodules in the pre-invasive group with no enhancement than in the pre-invasive group, which was statistically significant. (3) The CT value of 60-s scan was independent predictor of invasive adenocarcinoma (P = 0.019).ConclusionsNon-contrast enhanced plus two contrast-enhanced CT based on volume measurements can differentiate invasive pGGO from pre-invasive pGGO.
Highlights
Invasive pure ground-glass opacity and pre-invasive pure ground-glass opacity have different 5-year overall survival rate and risk of lymph node metastasis and the extent of resection
Non-contrast enhanced plus two contrast-enhanced Computed tomography (CT) based on volume measurements can differentiate invasive pure Ground-grass opacity (pGGO) from pre-invasive pGGO
In 2011, the concepts of adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA), invasive adenocarcinomas (IA) were introduced in a new classification published by the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) [1]
Summary
Invasive pure ground-glass opacity and pre-invasive pure ground-glass opacity have different 5-year overall survival rate and risk of lymph node metastasis and the extent of resection. The objectives of this study were to investigate the feasibility of non-contrast enhanced plus contrast-enhanced computed tomography in discriminating invasive pure ground-glass opacity from pre-invasive pure ground-glass opacity. The complete resection of pre-invasive pGGNs results in 100% disease-specific survival [2], in contrast, even after resection of invasive nodules, the 5-year overall survival rate is only 49–84% [4]. The risk of lymph node metastasis and the extent of resection are very different between pre-invasive and invasive adenocarcinoma [5]. As a non-invasive examination, contrast-enhanced CT has shown improved accuracy in the diagnosis of solitary pulmonary nodules [3, 6, 7]. We aimed to identify whether this type of contrastenhanced CT could predict the invasiveness of pGGO
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
