Abstract
Purpose
To investigate the differences of size and density measurements in assessing pure ground-glass nodules (pGGNs) growth, and compare the growth rates and growth proportions of the two methods during follow-up period.
Methods
Ninety patients with at least 3 consecutive thin-section chest CTs and confirmed 103 pGGNs on baseline CT were enrolled retrospectively. Using the two definitions of size and density to evaluate pGGNs growth with semi-automated segmentation. Then, the two methods were compared to assess differences in pGGNs growth.
Results
For the size and density methods to assess nodule growth, 50.5% and 26.2% showed interval growth at the last CT (p < 0.001). Among the 19 nodules that grew in both size and density, the volume doubling time (VDT) of solid component (mean, 317.1; standard deviation, 224.8 days) was shorter than total VDT (median, 942.8; range, 400.1–2315.9 days) (p < 0.001). Of the 27 growth pGGNs assessed by the density method, the growth rates at years 1 and 2 were 25.9% and 63.0%, while the growth rates of 52 growing nodules assessed by size method were 11.5% and 48.1%, respectively. Twenty of 103 (19.4%) nodules were classified into category 4A lesions, and 7 (6.8%) were 4B lesions.
Conclusion
Compared to size measurements, observed density increases have a higher proportion of early growth and faster growth rates in growing nodules. Clinicians need to pay close attention to the nodules of new solid components and make timely decision management.
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Data availablity
The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
Abbreviations
- CT:
-
Computed tomography
- pGGN:
-
Pure ground-glass nodule
- VOI:
-
Volume of interest
- m-CTA:
-
Mean-CT attenuation
- tVDT:
-
Total volume doubling time
- sVDT:
-
Solid volume doubling time
- IA:
-
Invasive nonmucinous adenocarcinoma
- MIA:
-
Minimally invasive adenocarcinoma
- AIS:
-
Adenocarcinoma in situ
- AAH:
-
Atypical adenomatous hyperplasia
- GGO:
-
Ground-glass opacity
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Funding
This work was supported by Dalian Science and Technology Innovation Fund (No. 2022JJ13SN078): Development of artificial intelligence models for predicting the growth rate and pathological types of lung adenocarcinomas presenting as ground-glass nodules.
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All authors contributed to the study conception and design. Conceptualization: [ZL], [YH]; Methodology: [ZX], [JZ]; Formal analysis and investigation: [YH], [JX]; Writing—original draft preparation: [YH]; Writing—review and editing: [ZL]; Resources: [WZ], [MZ]; Supervision: [WZ].
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Approval was granted by the Ethics Committee of the First Hospital of Dalian Medical University (No: YJ-KS-KY-2023–13, December 24, 2022). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.
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Since this study was a retrospective study, the Ethics Committee of the First Affliated Hospital of Dalian Medical University waived the requirement to obtain informed consent from the patients.
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He, Y., Xiong, Z., Zhang, J. et al. Growth assessment of pure ground-glass nodules on CT: comparison of density and size measurement methods. J Cancer Res Clin Oncol 149, 9937–9946 (2023). https://doi.org/10.1007/s00432-023-04918-5
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DOI: https://doi.org/10.1007/s00432-023-04918-5