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CT findings of minimally invasive adenocarcinoma (MIA) of the lung and comparison of solid portion measurement methods at CT in 52 patients

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Abstract

Objectives

We aimed to retrospectively investigate CT findings of minimally invasive adenocarcinoma (MIA) and to determine the appropriate method for measurement of solid portions in MIAs at CT.

Methods

From May 2012 to April 2014, 55 pulmonary nodules in 52 patients were pathologically confirmed as MIAs and were included in this study. CT findings of MIAs and measurements of solid portions at CT were evaluated by two independent radiologists.

Results

Mean size of MIAs was 10.5 mm ± 4.8 (range, 4–28 mm). Fifty-two MIAs manifested as 28 pure ground glass nodules (GGNs) (53.8 % %), 22 part-solid GGNs (42.3 % %), and 2 two solid nodules (3.8 % %) at CT. Lobulated border, bubble lucency, and pleural retraction were frequently found in both observers (26.9–42.3 % %). Differences according to window settings between solid portion size and invasive component size were not significantly different in both observers (p > 0.05). As for interobserver agreement, 95 % CIs for solid portion size in the mediastinal window setting (-2.2 to 3.4; mean, 0.6) were slightly narrower than those in the lung window setting (-2.6 to 3.1; mean, 0.3).

Conclusions

Nearly all MIAs appear as pure and part-solid GGNs. Mediastinal and lung window settings can be applied for measurement of solid portions at CT without a significant difference.

Key Points

• Nearly all MIAs appear as pure and part-solid GGNs.

• MIAs show frequent interval growth at follow-up.

• MIAs with solid portion ≥5 mm ranged from 7.7 % to 19.2 %.

• Mediastinal and lung window settings can be applied for solid portion measurement.

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Abbreviations

MIA:

minimally invasive adenocarcinoma

GGN:

ground glass nodule

IASLC:

International Association for the Study of Lung Cancer

ATS:

American Thoracic Society

ERS:

European Respiratory Society

AAH:

atypical adenomatous hyperplasia

AIS:

adenocarcinoma in situ

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Acknowledgments

The scientific guarantor of this publication is Dr. Jin Mo Goo. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This study has received funding by grant no 2013-0507 from the SK Telecom Research Fund. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, observational, performed at one institution.

Conflict of interest

All authors have no conflicts to disclose.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University College of Medicine, and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea

    Sang Min Lee, Jin Mo Goo, Kyung Hee Lee & Chang Min Park

  2. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

    Jin Mo Goo

  3. Department of Pathology, Seoul National University College of Medicine, Seoul, Korea

    Doo Hyun Chung & Jaemoon Koh

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  1. Sang Min Lee
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  2. Jin Mo Goo
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  3. Kyung Hee Lee
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  6. Chang Min Park
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Correspondence to Jin Mo Goo.

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Lee, S.M., Goo, J.M., Lee, K.H. et al. CT findings of minimally invasive adenocarcinoma (MIA) of the lung and comparison of solid portion measurement methods at CT in 52 patients. Eur Radiol 25, 2318–2325 (2015). https://doi.org/10.1007/s00330-015-3616-4

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  • DOI: https://doi.org/10.1007/s00330-015-3616-4

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